[Studies on Factors Influencing Influenza Vaccination Rates in Patients with Chronic Obstructive Pulmonary Disease]. / Untersuchungen zu Einflussfaktoren auf die Influenza-Impfraten bei Patienten mit chronisch obstruktiver Lungenerkrankung.

BACKGROUND : With low influenza vaccination rates among the chronically ill, approaches to increase these rates among risk patients with chronic obstructive pulmonary disease (COPD) are to be uncovered. METHODS : 120 COPD patients from Magdeburg filled out a questionnaire and were analyzed regarding the influenza vaccination status 2015/2016 or 2016/2017. Vaccinated and unvaccinated were compared in socio-epidemiological factors, the health belief model (HBM), self-efficacy (GESIS-ASKU), anxiety/depression (HADS-D) and disease processing (FKV-LIS). RESULTS : 62.5 % (n = 75) were vaccinated, 31.7 % (n = 38) unvaccinated, 5.8 % (n = 7) made no statement. In over or equal to 60-year-olds 76 % were vaccinated, in under 60-year-olds 42 % were vaccinated. 60 % (n = 72) knew to belong to a risk group. Unvaccinated indicated greater concern about side effects of the vaccination (p = .004) and drew a worse benefit-expense balance (p = .001). Unvaccinated were more often uncertain about the vaccination protection and the severity of influenza (p ≤ .001). Vaccinated were highly motivated to think about vaccination themselves and more often had a positive vaccination history (p = .001). COPD patients showed a lower self-efficacy than the reference group of the German general population (p = .000), vaccinated and unvaccinated did not differ (p = .418). No difference between vaccinated and unvaccinated was found in the processing of the disease and in depression and anxiety, but unvaccinated tended to give higher anxiety values. CONCLUSION : Measures should particularly target COPD patients under 60 years of age with a negative vaccination history and sensitize them as risk patients. Widespread uncertainties about the severity of influenza and vaccination protection should be addressed. It should be communicated that influenza vaccination does not lead to exacerbation. The vaccination recommendation should increasingly be made by pulmonologists.

Mediator production and tumorigenesis of murine monocyte lines.

A murine macrophage-like cell line P388D1 (PD1) and its subline PD2 were studied for mediator production and also for tumorigenic properties. When PD1 cells were cultured in a medium containing 5% fetal calf serum, the culture supernatants exhibited potent interleukin 1 (IL1) activity (also termed lymphocyte-activating factor). IL1 activity produced in unstimulated cultures was predominantly of a low-molecular-weight species (mol wt, 13,000-16,000), but in PD1 cultures stimulated with 10-20 microgram lipopolysaccharide/ml a major IL1 activity was associated with a substance(s) of 65,000-75,000 in molecular weight. The PD1 cell line was nontumorigenic in normal female, syngeneic, inbred DBA/2J mice but produced progressively growing tumors in animals that had been immunosuppressed by 450-rad whole-body X-irradiation and treatment with antithymocyte serum. Inoculation with PD1 failed to produce tumors in athymic nude mice, and the spleens of nude mice that rejected PD1 grafts contained significant levels of a theta-positive cell population(s). PD2, a nonadherent and nonphagocytic subline of PD1, produced very little IL1 but instead produced a potent lymphocyte-inhibiting factor in vitro. The PD2 cell line was highly tumorigenic in syngeneic DBA/2J hosts. These results indicated a direct association between tumorigenicity and the type of mediators produced by these murine macrophage cell lines.

Paradoxical stimulation of normal and leukemic rat hematopoiesis by monoclonal antibody to CSF-1 receptor.

We have recently developed a rat monoclonal antibody directed against the murine M-CSF receptor (c-fms). This reagent also inhibits in vitro colony formation by leukemic and normal rat splenocytes in response to M-CSF. At high antibody concentrations, the antibody augments, rather than inhibits, colony formation by rat cells in the presence of M-CSF, an effect that is not seen when murine cells are used as responders. The costimulatory and inhibitory activities of the monoclonal antibody preparations copurify in a number of purification methods, indicating that the costimulatory activity is intrinsic to the antireceptor antibody. Conversion of the antibody into monovalent Fab fragments by papain digestion destroys costimulatory activity. This finding raises a cautionary note for the in vivo use of intact monoclonal antibodies directed against growth factor receptors for the treatment of hematologic malignancies.

Enhancement of monocytopoiesis by granulocyte colony-stimulating factor: evidence for secondary cytokine effects in vivo.

Granulocyte colony-stimulating factor (G-CSF) is used with increasing frequency to reduce the neutropenic interval following dose-intensive chemotherapy. In mice, exogenous G-CSF reduces neutrophil recovery after 5-fluorouracil (5-FU) treatment from 14 to 8 days. G-CSF treatment also enhances recovery of blood monocytes; colony assays show increased numbers of macrophage and granulocyte-macrophage progenitors (CFU-M and CFU-GM) in the marrow. This unexpected effect of G-CSF treatment is dependent on endogenous M-CSF; antiserum to murine M-CSF inhibits both peripheral monocyte and monocytic progenitor recovery without affecting neutrophil or CFU-GM recovery. Conversely, the effect of M-CSF depletion is seen only in G-CSF-stimulated recovery; monocyte levels in mice treated with antiserum to M-CSF after 5-FU are indistinguishable from mice given 5-FU alone. No synergy between G-CSF and M-CSF can be demonstrated in vitro with either normal or 5-FU-treated marrow, indicating this G-CSF/M-CSF interaction must be indirect. These results reveal an unpredicted beneficial effect of G-CSF treatment on monocyte recovery and a role for endogenous M-CSF in rebound hematopoiesis.

Heterogeneity of murine mammary adenocarcinoma cell subpopulations. In vitro and in vivo resistance to macrophage cytotoxicity and its association with metastatic capacity.

Properties of Ts, a long-term tissue culture line of T1699 mammary adenocarcinoma of DBA/2 mice, and two of its sublines - TR2 and TLI-1-were comparatively studied. Ts tumors produced no spontaneous metastases, nor did i.v. injection of up to 1 X 10(6) Ts cells produce a lung tumor nodule. Ts cells were susceptible to macrophage cytotoxicity in vitro and i.v. injected cells were rapidly destroyed in the lungs. TLI-1 tumors spontaneously metastasized to the lungs, and i.v. injection of 1 X 10(3) TLI-1 cells produced approximately 15 lung nodules per animal. TLI-1 cells were least susceptible to both macrophage-mediated cytolysis in vitro and in vivo host antitumor mechanisms. TR2 cells were intermediate with respect to all these properties. Differences in their susceptibility to macrophage cytotoxicity were recognized not only by normal peritoneal macrophages but also by murine macrophage lines. On the other hand, all the subpopulations were uniformly resistant to NK activity in vitro. These findings suggest that resistance of tumor cells in vitro to macrophage cytotoxicity corresponds with their in vivo metastatic potential.

Collaboration between specific anti-tumor immunity and chemotherapeutic agents.

Treatment of DBA/2J mice bearing a T1699 syngeneic mammary adenocarcinoma (Ts) with a single intraperitoneal (i.p.) injection of 100 ug melphalan produced complete tumor regression in about 65% of the animals treated; however, tumors recurred in about 85% of these regressors after 15-25 days' remission. The drug regimen was ineffective against Ts tumors growing in immunosuppressed or immunodeficient animals. Stimulation of immunologically intact Ts tumor-bearers with bacterial lipopolysaccharide (LPS) or with phytohemagglutinin (PHA) 3 days prior to melphalan therapy, on the other hand, produced not only higher rates of tumor regression but also significant increases in the number of permanent cures. A tumor induced by T1699 subline TR2 was resistant to the same regimen, although Ts and TR2 cells were equally susceptible to the cytotoxic and growth-inhibiting activities of the drug in vitro. In contrast, the combination of specifically armed monocytes and melphalan in vitro produced enhanced killing of Ts cells but not of TR2 cells. Analysis of the collaborative cytotoxicity between immune effector cells and melphalan indicated that exposure of tumor cells to killer cells increased the drug susceptibility of the tumor cells, but not the reverse. These results suggest a possible mechanism for in vivo resistance of tumors to chemotherapeutic agents that is not directly associated with the drug resistance of the tumor cells in vitro.