Association between interleukin-4-producing T lymphocyte frequencies and reduced risk of graft-versus-host disease.

BACKGROUND: We have previously developed and used limiting dilution analysis to measure frequencies of alloreactive cytotoxic T cell precursors (CTLp) and interleukin (IL)-2-producing T helper cells (IL-2/HTLp) to assess the risk of graft-versus-host disease in bone marrow transplantation (BMT). However, no test has been available to measure precursor frequencies of the important IL-4-secreting subset. METHODS: We have now established a limiting dilution analysis to measure the frequency of IL-4-producing T helper cells (IL-4/HTLp) using the IL-4-responsive indicator cell line CT.h4S and have applied this assay to measure alloreactive IL-4/HTLp frequencies in BMT donor-recipient pairs. These frequencies were then analyzed in the context of clinical data to assess the relationship between the number of donor anti-recipient IL-4-secreting T cells and disease outcome. RESULTS: Frequencies of IL-4/HTLp have been studied in HLA-identical siblings, HLA-"matched" unrelated, and HLA-mismatched combinations and found to range from approximately 1/500,000 in HLA-identical sibling pairs to -1/2,000 in HLA-DR-mismatched pairs. These frequencies were independent of those for IL-2/HTLp and showed a negative correlation with those for CTLp. Clinical follow-up of 30 patients showed that high IL-4/HTLp frequencies are associated with a reduced risk of severe graft-versus-host disease. High IL-4/HTLp frequencies may also indicate an increased risk of leukemia relapse. CONCLUSIONS: Our data suggest that measurement of IL-4/HTLp frequencies provides information distinct from that obtained with CTLp and IL-2/HTLp. This new assay provides a valuable additional method for optimizing donor selection in unrelated BMT.

Diagnostic role of testicular fine needle aspiration biopsy in male infertility.

OBJECTIVE: To study the diagnostic role of fine needle aspiration biopsy (FNAB) of the testis in male infertility. STUDY DESIGN: A retrospective study of 586 cases of infertile males with oligospermia and azoospermia. The material obtained was stained with Diff-Quik. The proportion of Sertoli cells versus spermatogenic cells was studied. RESULTS: Cytologic examination revealed normal spermatogenesis in 10.2%, hypospermatogenesis in 31.4%, Sertoli cells only in 30.2% and an atrophic pattern in 28.6%. CONCLUSION: The patterns recognized by FNAB were comparable to those obtained by open biopsy. However, FNAB is less invasive, with very few complications. The procedure was well tolerated by all patients. There were very few complications. The findings of this study support the contention that FNAB of the testis is a reliable, relatively noninvasive procedure that has an important role in male infertility.