Random outcomes of allergen-specific responses in atopic families.

BACKGROUND: Allergens are common non-infectious antigens to which people will mount T cell dependent humoral responses. Among genetically susceptible individuals, an antigen-specific response results involving the production of allergen-specific IgE (atopy). OBJECTIVE: Determine if this susceptibility is manifested as an inherited, allergen-specific trait or a random response to allergens among susceptible people. METHODS: We evaluated allergen-specific outcomes in 1099 members of families with positive atopic history (26 multi-generation and 112 nuclear families). Each was tested for sensitivity to 14 common allergens by standardized skin prick test (SPT), a marker of specific IgE production. Over 15,000 individual SPT's were evaluated. Among five randomly selected multi-generation families (N=163), semi-quantitative determinations of Amb a 1-specific IgA1,2 and IgG1-4 were determined in three groups: (A) Amb a SPT(+)/Amb a 1-IgE(+), (B) Amb a SPT(-)/Amb a 1-IgE(+), (C) Amb a SPT(-)/Amb a 1-IgE(-). RESULTS: By rank correlation statistics, there were no discernible 'patterns' of specific SPT outcomes among any of the multi-generation families, suggesting that environmental exposure rather than allergen-specific inheritance determined the responses. This was confirmed among the nuclear families since the conditional SPT outcomes among children were independent of the SPT responses of their parents. Among five randomly selected multi-generation families, the relative proportionate concentrations of the Amb a 1-specific IgA and IgG subclasses were comparable, regardless of atopic sensitization to the ragweed allergen Amb a. CONCLUSION: While the general propensity for atopy may be inherited, an individual's specific atopic outcome is a random variable independent of familial sensitization patterns.

Evidence of an affinity threshold for IgE-allergen binding in the percutaneous skin test reaction.

BACKGROUND: Atopy is an aberrant immune response involving allergen-specific IgE production, though serum IgE concentration is not an entirely reliable diagnostic tool, particularly for epidemiological and genetic studies. There is no clear correlation between IgE and other indicators of atopy such as skin prick tests (SPT)s, and physiological associations are difficult to justify in cases with detectable IgE but negative SPT results. OBJECTIVE: IgE reflects the number of molecules available to produce an atopic response, but the degree of the response is determined by the binding strength (affinity) between receptor-bound IgE and the allergen. We sought to determine if there was an association between binding affinity and SPT results in people with histories of atopy. METHODS: Standard SPTs (whole allergen extracts) were administered to people with histories of sensitivities to ragweed and house dust mite. The concentrations and affinities of serum allergen-specific IgEs were determined using the purified allergens Amb a 1 and Der p 1. RESULTS: There was a positive correlation between weal area and allergen-specific IgE among SPT-positive donors. However, for those individuals with detectable amounts of allergen-specific IgE, there was considerable overlap of IgE values between SPT-positive and -negative groups. Among sensitized donors, IgE-allergen interactions were characterized by two or three specific reactions of very high affinity (K(A) range 10(8) -10(11) M). Negative SPT reactions were associated with lowered IgE binding affinities to major allergens. This delimited two groups with atopic disorders: specific IgE(+)/ SPT(+) and specific IgE(+)/SPT(-). CONCLUSION: The product of antibody affinity and concentration, which we define as antibody capacity (CAP = K(A) x IgE), is more informative with regard to describing allergen sensitivity than antibody concentration alone. Antibody binding capacity provides physiological evidence of atopy in some subjects who do not test positively by common methods and suggests an affinity threshold to produce a positive SPT reaction.

Altered allergen binding capacities of Amb a 1-specific IgE and IgG4 from ragweed-sensitive patients receiving immunotherapy.

BACKGROUND: The mechanisms for the effectiveness of allergen immunotherapy (IT) are not well understood. The binding potential for immunoglobulins is a function of both antibody concentration and affinity (K(A)). PURPOSE: The purpose was to perform a cross-sectional preliminary study to investigate any differences in allergen-specific antibody affinity and concentration following ragweed immunotherapy by introducing a new concept of antibody binding capacity ([Ig] X K(A)). METHODS: The binding capacity of allergen-specific IgE and IgG4 was determined for ragweed-allergic individuals undergoing ragweed immunotherapy and compared with the capacity of ragweed-specific IgE and IgG4 for allergic individuals not receiving immunotherapy. RESULTS: The mean binding capacity for IgG4 after long-term immunotherapy was 1.6 log units higher (P < .0001) than for individuals not receiving IT. The binding capacity for allergen-specific IgE was 1.2 log units lower following long-term immunotherapy (P < .0001) compared with individuals not receiving ragweed IT. CONCLUSIONS: We hypothesize that a primary effect of immunotherapy is to increase IgG4 binding capacity and concomitantly decrease IgE binding capacity.

Characterization of polyclonal allergen-specific IgE responses by affinity distributions.

Polyclonal IgE responses have been previously characterized by allergen-specific antibody levels and by identification of amino acid sequences related to immunodominant epitopes. However, the binding affinities related to these antibody families are not well known. Using sera from donors with known sensitivities to ragweed or house dust mite allergens, we studied the binding reactions between the purified allergens Amb a 1 and Der p 1 and allergen-specific IgE's by determining affinity distribution functions. The distributions of binding affinities only exhibited a few dominant reactions indicated by peaks in an affinity distribution display. In all the donors tested, there were two dominant peaks and in 2/3 of the cases there was a third peak for both Amb a 1 and Der p 1. We further characterized the polyclonal interactions between IgE and Der p 1 by inhibiting the specific binding of IgE using peptide fragments known to be constituents of Der p 1 epitopes. Each peptide inhibited only a single peak in the affinity distributions. It would appear that the peaks in the affinity distribution represent antibodies directed to single epitopes. These results suggest that in our atopic population the response is surprisingly uniform. The bulk of the IgE response (70-80%) is of high affinity (10(8)-10(11) M(-1)) and directed towards a few epitopes. The relative affinities towards epitopes seem to be determined by the structure of the epitope and not variations of individuals' immune responses.

Expression of IgH chain genes in antibody response to ragweed and purified Amb a 1: evidence for differential regulation of isotype production.

A survey of the work with Ig response to allergens carried out previously reveals an allergen-specific response both by IgE and all of IgG subclasses. Response of non-sensitive people is characterized by the appearance of a variety of the IgG subclasses. We have reexamined ragweed and Amb a 1 specific Ig response in 54 nonsensitive and 147 atopic or atopic-allergic people using a new inverse sandwich immunoassay allowing discrimination based on antibody affinity. We show that non-sensitive people present no, 0 out of 54, Ig response with affinities higher than Ka 10(7) M(-1). The subpopulation of 66 atopics who never have experienced desensitization responds vigorously and solely (56 out of 66) with genes of the sequence gamma2-alpha2. Only ten showed an additional weak response from gamma1-alpha1. This suggests a possible association between the atopic state and selective activation of part of the gene sequence.

Dynamic phenotypic restructuring of the CD4 and CD8 T-cell subsets with age in healthy humans: a compartmental model analysis.

In healthy humans, phenotypic restructuring occurs with age within the CD3+ T-lymphocyte complement. This is characterized by a non-linear decrease of the percentage of 'naive' (CD45RA+) cells and a corresponding non-linear increase of the percentage of 'memory' (CD45R0+) cells among both the CD4+ and CD8+ T-cell subsets. We devised a simple compartmental model to study the age-dependent kinetics of phenotypic restructuring. We also derived differential equations whose parameters determined yearly gains minus losses of the percentage and absolute numbers of circulating naive cells, yearly gains minus losses of the percentage and absolute numbers of circulating memory cells, and the yearly rate of conversion of naive to memory cells. Solutions of these evaluative differential equations demonstrate the following: (1) the memory cell complement 'resides' within its compartment for a longer time than the naive cell complement within its compartment for both CD4 and CD8 cells; (2) the average, annual 'turnover rate' is the same for CD4 and CD8 naive cells. In contrast, the average, annual 'turnover rate' for memory CD8 cells is 1.5 times that of memory CD4 cells; (3) the average, annual conversion rate of CD4 naive cells to memory cells is twice that of the CD8 conversion rate; (4) a transition in dynamic restructuring occurs during the third decade of life that is due to these differences in turnover and conversion rates, between and from naive to memory cells.

Diminished cell-cell binding by lymphocytes from healthy, elderly humans: evidence for altered activation of LFA-1 function with age.

We studied the kinetics of cell-cell adhesion by monocyte-depleted peripheral blood lymphocytes with a stirred-cuvette aggregometer using samples from healthy young (mean age = 25 years) and healthy elderly (mean age = 75 years) human donors. This was a very reproducible assay, as there was virtually no intraindividual variability and very little interindividual variability among donors of the same age group. In all cases, aggregation of cells began immediately upon addition of the protein kinase C activator phorbol myristate acetate (PMA) or the calcium ionophore ionomycin, and continued until reaching an asymptotic limit by 20 minutes or less. Unstimulated cells did not aggregate during this time. The rate of aggregate formation and total amount of aggregation (using young donors' cells) varied between PMA- and ionomycin-stimulated cells, suggesting different mechanisms for initiating cellular aggregation, or possibly, different peripheral blood lymphocyte subsets affected by these activating agents. However, for both stimuli, the rate of aggregation and the total amount of cellular aggregation were significantly lower with the elderly donors' cells. Further, aggregation was Ca2+/Mg2+ dependent, and the reaction required metabolically active cells, as the reaction was inhibited by the addition of sodium azide and 2-deoxy-D-glucose in both donor groups. Pretreating cells with the actin polymerization inhibitor cytochalasin B resulted in 35-40% inhibition of aggregation among young donors' cells, although, interestingly, there was no apparent effect upon the cells capable of forming aggregates in the old donor group. In both donor groups, aggregation by activated cells could be partially blocked by pretreating cells with monoclonal antibodies directed against the alpha and beta chains of the integrin leukocyte function-associated antigen-1 (LFA-1) (CD11a/CD18). These results show that there is diminished cell-cell binding among lymphocytes from healthy, elderly humans, and this is partly due to altered activation of LFA-1 function with age.

Age-associated changes in human T cell phenotype and function.

We used a limiting dilution method to estimate the proportion of T lymphocytes that could respond to PHA by producing IL-2, in peripheral blood mononuclear cells from healthy adult donors ranging in age from 18 to 81 years. The donors were selected using the guidelines of the SENIEUR protocol to exclude samples from donors not in optimal health. The frequency of PHA responsive, IL-2 producing T cells was found to decline with age, even though there was no corresponding change in the proportions of cells expressing the CD3 or CD4 determinants. There was, however, a statistically significant increase in the proportion of CD4 and CD8 cells expressing the CD45R0 determinant, thought to be a marker for memory T cells, and a corresponding decline in cells expressing the CD45RA marker found on naive peripheral T cells. The decline in the proportion of mitogen-reactive T cells in older donors, although statistically significant, was smaller than that seen in studies of aging mice, probably because the assay conditions for human T cell function are preferentially stimulatory for memory T cells, which accumulate in old age.

Evidence for lymphocyte chemotaxis toward monocytes during PHA-induced aggregation in vitro.

An important, early phenomenon during the development of immune cell interactions in vitro is the formation of multicellular aggregates. We have developed a quantitative assay to determine the kinetics of multicellular aggregate formation within a heterotypic population of cells on a flat surface. This assay follows the time rate of change in the value of an aggregation index for cells in undisturbed culture. For an initial, well-separated population of cells, the index is a minimum and remains at this value if the cells do not move and interact. By contrast, for conditions that promote active cell movement followed by interaction, the index value increases with time. The index, which reflects cells' relative spatial distributions, is an "indirect enumeration" of the number of cells within aggregates as a function of time. We used this index to follow the aggregative behavior of a population of freshly isolated human peripheral lymphocytes and monocytes. Previous studies have shown that monocytes are centrally located within aggregates and that lymphocytes move to surround monocytes. In order to test if lymphocyte movements are random or directed prior to interactions with monocytes, we formulated a simple model to describe changes in the expected number of cells in an "idealized aggregate" as a function of time. A comparison of the model curves with curves generated from the changes in the aggregation index shows that the best fit derives from a model that involves directed movement of lymphocytes toward monocytes. These results suggest that monocytes produce a chemoattracting agent for lymphocytes for these experimental conditions.

Monocyte requirement for mitogen-induced aggregation of human peripheral mononuclear leukocytes in vitro.

Formation of distinct multicellular aggregates is one of the phenomena associated with activation of quiescent human mononuclear leukocytes in vitro. Aggregate formation involves active cell motility and enhances cell-cell interactions required for an optimal proliferative response of T-cells stimulated with agents like phytohemagglutinin. We have developed an assay to quantitate the rate at which motile cells form aggregates on a flat surface. This assay follows the time rate of deviation of cells in undisturbed culture away from an initial random distribution using an "aggregation index." We used this assay to establish minimal culturing conditions required to observe an aggregation response for a partially purified mononuclear leukocyte population. We also studied the ability to aggregate of various subpopulations enriched for T- and B-lymphocytes and monocytes and found evidence for a monocyte requirement for lymphocyte aggregation. In a second assay, we followed the rate of entry of esterase positive monocytes into aggregates and compared this to the rate of entry of mononuclear cells in toto. We found that monocytes are preferentially associated with non-esterase positive cells within one hour of PHA stimulation. The results support the conclusion that monocytes play a central role in directing the motility of human T-lymphocytes leading to their aggregation response in tissue culture.

Evidence for expansion of a population of lymphocytes with reduced or absent T3 expression in aged human donors.

In a previous report, we described an unusual pattern of T cell associated surface marker expression in unfractionated mononuclear cells from aged donors; an excess of T4 and T8 positive cells relative to T3 positive cells. This study further characterizes these cells on the basis of density, adherence to nylon wool and quantitative expression of cell surface markers. We find that the population of lymphocytes responsible for the unusual surface marker expression is of low density, adheres to nylon wool, and is present in small numbers in young donors. The adherent cells have a reduced quantitative expression of the T3 antigen, no change in the antigen density of T4 and T8, and have increased expression of the T10 antigen. These cells do not have the characteristics of large granular lymphocytes, monocytes, B cells with unusual marker expression, or thymocytes poised for export to peripheral blood. We suggest that these cells, found in increased numbers in aged humans, may represent an expansion of a population of T lymphocytes with absent or reduced T3 antigen expression found normally in smaller numbers in young adults. T lymphocyte antigen receptor density has been quantitatively linked to expression of the T3 antigen. Thus, our results imply that aging may lead to decreased T cell surface antigen density, which may account in part for decline in T cell function with age.

Enhancement of mitogen response and surface marker analysis of lymphocytes from young and old donors after preliminary incubation in vitro.

We have examined the detailed kinetics of PHA induced proliferation of freshly isolated mononuclear cells from young and old human donors. Our studies confirm that donors over the age of 60 years may have a decreased number of PHA responsive cells and that these cells have a significantly diminished rate of entry into the first cell cycle. Age of the donor does not affect the time at which significant numbers of cells appear in first S-phase, the duration of first S-phase, the doubling time in exponential growth, and thymidine uptake per cell. Cells from young and old donors were also cultured in medium supplemented with pooled human serum for 1 or 2 days prior to the PHA response assay. After 2 days of preliminary culture, the PHA response in both young and old is significantly enhanced, with a greater enhancement in the old. The basis of this enhancement appears to be a significant increase in rate of entry into the first cell cycle. None of the other kinetic parameters were significantly altered. The magnitude of the rate enhancement in old donors' cells eliminated the difference in entry rate between young and old after 2 days of preliminary culture. The same rate enhancing effects were seen in the presence of serum pooled from young or old donors. There is no statistically significant change in the number of responding cells after preliminary culture. We had previously suggested, based on lactate dehydrogenase (LD) subunit ratio and patterns of T cell associated surface markers, that less differentiated subpopulations of T cells exist in elderly donors. After preliminary culture, no significant change was seen in the proportions of cells positive for T3, T4, T8, T10 and Ia surface antigens and the unusual pattern of surface marker distribution was still present on the old donors' cells. It appears that the greater rate enhancement in old donors' cells after preliminary culture may not be due to induced maturation of the possibly less differentiated T cell populations described previously. The results do suggest that these subpopulations may be non-responsive to PHA.

Unusual pattern of surface marker expression on peripheral lymphocytes from aged humans suggestive of a population of less differentiated cells.

Monoclonal antibodies were used to detect the surface antigens T3, T4, T8, and T10 on the peripheral blood lymphocytes of 26 aged (14 female and 12 male, mean age 89) and 28 young (14 female and 14 male, mean age 29) subjects. In the aged subjects, independent of the sex of the donor, the sum of the percent or absolute number of T4- and T8-positive cells was significantly greater than the number of T3-positive cells (p less than 0.001). There was also a significant increase in the percent and absolute number of cells positive for the T10 antigen with age (p less than 0.01). Analysis of individual cell surface markers revealed that the percent and absolute number of T3-positive cells was decreased only in old females, with no difference between old males and the young donors. The expression of T4 was not affected by age or sex, but both the percent and absolute number of T8-positive cells were decreased in females relative to males, with no effect due to age. These findings are consistent with the presence of a population of peripheral T cells in advanced age with a thymocyte-like pattern of surface marker expression. This conclusion is supported by previous work showing a less differentiated pattern of LDH isoenzyme distribution in the T cells of persons of advanced age.

Evidence for a less differentiated subpopulation of lymphocytes in people of advanced age.

The ratio of the lactate dehydrogenase subunits, H/M, is shifted toward lower values in thymocytes, and in high-density T cells in normal peripheral blood. The results presented here indicate that the T cells, but not B cells or monocytes, of donors greater than 75 years' old have a significantly reduced H/M ratio relative to young adults. This reduced H/M ratio appears to be correlated with a diminished percentage of OKT3 positive cells in the old donors. However, the density distribution of cells from young and old on Percoll gradients indicates that the T cells with lower H/M ratio in the elderly may represent a distinct, and possibly unique, less differentiated T cell type.

Experimental pancreatitis after surfactant exposure.

The effects of pancreatic intraductal infusions of the surface active pancreatic ductogram enhancing agent, polyoxyethylene hydrogenated castor oil, were studied in the dog. Moderately high pressure retrograde infusions of 5 per cent polyoxyethylene hydrogenated castor oil into the main pancreatic duct resulted in pancreatitis-like changes significantly greater than those seen in the saline solution control group. These changes persisted despite buffering of the agent to physiologic pH and the elimination of nonphysiologically high pressure by direct ductal perfusion. Similar inflammatory changes were associated with ductal perfusion using oleic and, to a lesser degree, ricinoleic-fatty acids at concentrations of 10(-4) molar sufficient to account for the titratable acidity of 5 per cent polyoxyethylene hydrogenated castor oil. It is postulated that residual-free fatty acids may play some role in polyoxyethylene hydrogenated castor oil related toxicity. The surface active properties of the agent may also be involved. Caution and further research are recommended prior to widespread use of the agent in endoscopic retrograde pancreatography.

Effects of dextranases on attachment of Streptococcus mutans to hydroxyapatite.

A Fusarium dextranase and a Penicillium dextranase were compared for their relative ability to quantitatively reduce the adsorption of (3)H-labeled Steptococcus mutans cells onto hydroxyapatite. Fusarium dextranase-treated hydroxyapatite disks caused a statistically significant decrease in the hydroxyapatite adsorption of both the OMZ 176 and NCTC 10449 strains of S. mutans relative to untreated control disks. The extent of initial bacterial adsorption was not promoted by sucrose-dependent glucan synthesis. Since the Fusarium dextranase has a much greater affinity for hydroxyapatite than the Penicillium dextranase, it could represent an enzyme with improved decay-preventive therapeutic properties. This was concluded because the Fusarium dextranase may interfere with both the initial attachment and later glucan-dependent accumulation of dental plaque microorganisms.