Breakdown of T-cell ignorance: The tolerance failure responsible for mainstream autoimmune diseases?

This article explores the possibility that the major autoimmune diseases come about because of the breakdown of T lymphocyte ignorance - that state in which antigen and lymphocyte have never come together in such a way as to induce tolerance or an immune response. By use of transgenic technique to place a foreign antigen/peptide in various mouse tissues the widespread occurrence of ignorance has been observed and information obtained on when it is likely to occur. Now, with the advent of tetramer technique to enrich specific T cells and the recognition of lymphocyte markers indicating whether or not antigen interaction has taken place, ignorance of genuine self-antigens is being examined in mouse and man.

The immunological personality of close relatives of SLE patients.

Immunological abnormalities seen in relatives of patients with autoimmune disorders can be useful in understanding the pathogenesis of the disease since, unlike in patients, they cannot result from the disease process or drug treatment. In this article we present a brief overview of our studies of the basic immunological status of close relatives of SLE patients. We looked at blood levels of IgG, IgM and antibodies to double-stranded DNA, as well as at NK cell numbers and cytotoxic activity and the levels of NKT, B and T cells.

Proliferation assay amplification by IL-2 in model primary and recall antigen systems.

Background: It can be difficult to register a weak proliferative response of T lymphocytes to an antigen, particularly in a simple culture system of peripheral blood mononuclear cells (PBMC). Here we assess the usefulness of the cytokine IL-2 in amplifying such a response.

Methods: PBMC from healthy donors were cultured in the presence or absence of keyhole limpet haemocyanin (KLH), an antigen to which people have not been previously exposed.

Two paradoxes and a surprise on the road to an understanding of systemic lupus erythematosus.

Whereas systemic lupus erythematosus (SLE) as normally encountered results from the coming together of a complex mix of genetic and environmental factors, SLE also develops in virtually all those rare people who lack a functional gene for the first component of complement (C1q). The pathogenic IgG antibodies against double-stranded DNA characteristic of the disease are made in response to nucleosomes - the package of DNA and histone molecules forming the unit structure of chromatin - which are present in apoptotic cells. Analysis of the C1q phenomenon illuminates the arrangements that are normally in place to ensure tolerance is maintained to nucleosomal antigens.

Serendipitous evidence of T lymphocyte activation in close female relatives of patients with systemic lupus erythematosus.

A well-recognized characteristic of the autoimmune disease, systemic lupus erythematosus (SLE), is the high level of activated T cells present in the blood. Because of the increased size and granularity of activated T cells, in flow cytometry one might expect to find increased numbers of cells falling outside a standard light-scatter lymphocyte gate, and indeed we now report that the percentage of T lymphocytes in the gate (% TiG) was below the normal range in 23 of 58 (40%) female patients because of increased scatter values. However, the surprising additional observation was made that 18 of 30 (60%) female first-degree relatives of the patients also fell below the normal % TiG range, suggesting the presence of T cell activation in these relatives.

Natural killer T cells in families of patients with systemic lupus erythematosus: their possible role in regulation of IGG production.

Objective: To determine whether there is a link between the frequency of natural killer T (NKT) cells and high levels of IgG in patients with systemic lupus erythematosus (SLE) and their relatives.

Methods: Blood samples were obtained from patients with SLE, their first-degree relatives, patients with rheumatoid arthritis (RA), and healthy control subjects. The frequency of NKT cells (defined as CD56+ T cells) was expressed as a percentage of total blood lymphocytes.

Anomalies in the ionic properties of serum albumin.

The documented difference in the isoionic points of native and unfolded serum albumins is revisited with computational methods. Good agreement between calculated and measured DeltapIs is found, with the molecular origin appearing to reside in a diverse set of carboxyl group titrations. Although histidine ionization plays only a minor role in bringing about the DeltapI, the identification of three histidine residues with low computed pK(a)s (around pH 5) suggests an explanation for the mismatch between experimentally derived group pK(a)s and the pI of the native protein.

Natural killer cell activity in families of patients with systemic lupus erythematosus: demonstration of a killing defect in patients.

Natural killer (NK) cell cytotoxic activity and cell frequency, expressed as a percentage of total lymphocytes, have been determined in peripheral blood mononuclear cells from first-degree relatives of patients with systemic lupus erythematosus (SLE), the patients themselves, a group of rheumatoid arthritis (RA) patients and controls. Low levels of killing activity relative to controls were found in some members of all groups with the extent of depression falling into two ranges. Moderate reductions were seen in female (3/31, 10%) and male (4/14, 29%) relatives of SLE patients, female (12/60, 20%) and male (3/4, 75%) SLE patients and female RA patients (6/17, 35%).

A two-step hypothesis for the appearance of autoimmune disease.

Two phenomena are likely to be central to an understanding of how autoimmune disease comes about--immunological tolerance and ignorance. Yet ignorance, the state where antigen and lymphocyte have never come together in such a way as to induce either tolerance or an immune response, is often ignored in recent discussion. This article reviews evidence that has led to the suggestion that most autoimmune disease arises from termination of ignorance.

Counter-proliferative effects of nucleosomal antigens in cultures from lupus patients.

Blood mononuclear cells from 20 lupus patients were cultured in the presence of nucleosomal antigens to determine whether they induce lymphocyte proliferation. The predominant effect seen, however, was one of inhibition of the background proliferation. Such inhibition was rare with cells from female or male controls.

Spontaneous immunoglobulin-producing capacity of cultures from lupus patients and normal donors following depletion of cells expressing CD19 or CD38.

Cells spontaneously secreting IgG or IgM (ISC) are present at a high level in the blood of patients with systemic lupus erythematosus (SLE). By use of magnetic-bead techniques, mononuclear cells from such patients and healthy donors were fractionated according to expression of CD19 or CD38 and the cell fractions were then cultured in the absence of added mitogen/antigen for 5/6 days. Supernatant IgG and IgM were determined and, in addition, in the CD38 experiments ISC were enumerated both before and after culture.

B lymphocyte hyperactivity in families of patients with systemic lupus erythematosus.

Blood cells spontaneously secreting IgG and IgM and the level of plasma immunoglobulins and antibodies to dsDNA, ssDNA and influenza virus haemagglutinin have been determined in families of patients with SLE, in 'normal' families and groups of 'normal' individuals. IgM values were consistently higher in females than in males. About one in three of healthy blood relatives gave values in excess of the sex-matched control range in one or more of these test, particularly notable being raised values of IgG anti-dsDNA and total IgG shown by female relatives.

Inhibition of mouse spleen cell activity by organotin compounds: effect of attachment of a maltose residue to the organotin group.

Studies are reported on the inhibition of DNA synthesis and the lowering of cell viability caused by bis(tributyltin) oxide in mouse spleen cells cultured in the presence and absence of the B-lymphocyte mitogen, bacterial lipopolysaccharide. When a maltose residue is introduced into the organotin compound these toxic effects are increased. It is suggested that the maltose residue facilitates entry of the organotin compound into the cells.

Does mitogen-induced antibody production by normal blood cells mimic spontaneous production in lupus?

Blood cells from patients with systemic lupus erythematosus (SLE) showed a raised level of spontaneous IgG production that included antibodies to DNA and to common environmental antigens (influenza virus haemagglutinin, adenovirus hexon and mannan from Candida albicans). In contrast, no IgG antibody was produced against an antigen not normally encountered in the UK (egg antigen from Schistosoma mansoni) or a self-antigen not generally associated with SLE (thyroglobulin). IgM production was raised to a lesser extent and only antibodies to DNA were detected.

Spontaneous antibody-secreting cells against DNA and common environmental antigens in systemic lupus erythematosus.

Cells spontaneously secreting IgG or IgM antibodies to DNA or to common environmental antigens--influenza virus haemagglutinin, adenovirus hexon and mannan from Candida albicans--have been enumerated by ELISA spot in blood from patients with systemic lupus erythematosus (SLE) and normal donors. Mean values were raised for all antigens in the disease, with those for DNA being no greater than for the other antigens. In normal donors, levels of IgM-secreting cells were similar for DNA and the environmental antigens whereas virtually no IgG anti-DNA secreting cells were found.

Tuberculin sensitivity and an interaction of leucocyte and plasma factors involving fibrinogen.

Lysates of blood leucocytes from strong tuberculin-positive reactors contained smaller particles of insoluble protein-rich material than did similar preparations from negative donors. The phenomenon was dependent on the presence of small quantities of plasma in the original leucocyte suspensions: when this was removed or replaced by serum both groups of donors produced particles of the smaller size. When the experiments were repeated in the presence of 125I-fibrinogen, larger particle size was found to be associated with an increased proportion of radioactivity becoming firmly bound to the insoluble material.

B lymphocyte activation in systemic lupus erythematosus: spontaneous production of IgG antibodies to DNA and environmental antigens in cultures of blood mononuclear cells.

IgG antibodies to DNA, influenza virus haemagglutinin (HA), adenovirus hexon (HX) and mannan from Candida albicans (MN) have been determined in supernatants from 2-day unstimulated cultures of peripheral blood mononuclear cells from SLE patients and controls. Mean values were much higher in the SLE group, with from 20% (MN) to 85% (DNA) of patients giving values above the normal range. Although a significant correlation was observed between anti-DNA and anti-HA production, anti-HX and anti-MN showed no such correlations.

Leucocyte migration inhibition in diphtheria toxoid hypersensitivity.

A donor who was highly reactive to diphtheria toxoid (DT) in delayed hypersensitivity and in lymphocyte transformation showed scant evidence of antigen-induced inhibition in the direct leucocyte migration agarose test. Other donors, weak or negative to DT in skin test and transformation, did show evidence of inhibition. Although the migration test is useful in assessing cellular reactivity to tubercular antigen, these results question its suitability for DT.

Evaluation of an ELISA system for determination of class-specific antibodies to native and denatured DNA in man.

Enzyme-linked immunosorbent assays (ELISA) have been set up for determination of plasma IgG and IgM antibodies to native (n) and denatured (d) DNA. Normal male and female donors generally gave low values in the assays for IgG; IgM control values were higher, particularly in females. Mean values for patients with systemic lupus erythematosus (SLE) were greatly raised in all four categories of assay in relation to the control (female) group.

The effect of hydrocortisone on PWM and LPS-induced immunoglobulin production in blood leucocytes from patients with systemic lupus erythematosus.

The effect of hydrocortisone (HC) has been investigated on PWM and LPS-induced immunoglobulin (Ig) production by blood mononuclear leucocytes (MNL) from normal donors and patients with systemic lupus erythematosus (SLE). In the absence of HC, PWM stimulated Ig production in normal but not in SLE cells. In the presence of HC, the normal PWM response was greatly enhanced and a strong response was now seen in SLE.

Dual action of leucocyte dialysates and of thymosin on the recovery of sheep-cell-rosetting capacity in trypsinized human lymphocytes.

Trypsinization of human blood lymphocytes abolishes their capacity to form rosettes with sheep erythrocytes (E-rosettes) and this is regained in part on incubation of the cells at 37 degrees C for 3 hr. The recovery of rosetting capacity was found to be accelerated in the presence of dialysable extracts of human leucocytes (DLE) or bovine thymosin fraction 5 (THFV). For both DLE and THFV two types of effect were demonstrated.

Effects of human transfer factor on the migration of guinea-pig macrophages: is there an antigen-specific activity?

Dialysable transfer factor (TF) prepared from the buffy-coat cells of tuberculin-positive human donors exerted antigen (PPD)-dependent inhibition of migration of guinea-pig peritoneal exudate cells (PEC) provided that migration of the cells was not strongly affected by PPD alone. TF from tuberculin-negative donors did not do this. The effect could be better demonstrated with tuberculin-sensitive than with normal PEC.