The test of non-specific cell-mediated response in animals with transplantable tumours stimulated with calf thymus extract

Investigations were carried out on the non-specific cell-mediated response in mice with transplantable tumours: LLC in mice C57Bl and F1(C57Bl X C3H), and SAL-l tumour in Balb/c mice. The malignant cells were implanted subcutaneously for observation of changes in the non-specific cell-mediated response at the time of the local growth of the tumour, and injections into the vein or into the foot-pad were made for studying the non-specific cell-mediated response at the time of tumour dissemination. In each series of the experiments the animals received an extract of calf thymus--the preparation TFX-Polfa. The control groups had the tumour cells implanted or injected but were not given TFX. For determining the non-specific cell-mediated response the animals were immunized with picryl chloride. In both experimental models, that is with subcutaneous implantation and with injections intravenously or into the foot-pad a decrease of the non-specific cell-mediated response was observed progressing gradually with extension of the tumours. Long-term administration of TFX in doses of 0.1 mg per mouse prevented the decrease of the non-specific cell-mediated response in the first place in mice with subcutaneous implantations. In mice with malignant cells injected intravenously or into the foot-pad TFX administration had no evident effect on the value of the test. This observation suggests that TFX prevents the development of a secondary immune deficit in mice with subcutaneous transplanted tumours--that is mainly at the time of local growth of the tumour, but is of little use in the phase of tumour dissemination.

Effect of red cell transfusions, thymic hormone and deoxycytidine in severe combined immunodeficiency due to adenosine deaminase deficiency

A child with severe combined immunodeficiency due to adenosine deaminase deficiency was treated with thymic hormone (TP1) alone, thymic hormone with red cell transfusions and finally with a combination of these and parenteral deoxycytidine. TP1 alone produced no benefit while the addition of red cell transfusions resulted in only partial immunological restoration despite improvement in clinical and biochemical findings. Deoxycytidine given subcutaneously produced no additional benefit in any of the parameters measured.

Treatment of cell-mediated immunodeficiency with calf thymic hormone (T.P.I.)

Eight children, four with combined immunodeficiencies and four with isolated T cell defects were treated with TPI, a crude calf thymic extract. Assessment of response was made on clinical grounds and by monitoring of immune function (T and B cell numbers, immunoglobulin levels, PHA response and delayed cutaneous reaction to Candida antigen). One child with severe combined immunodeficiency showed marked clinical improvement together with reconstitution of T cell numbers and, surprisingly, B cell numbers and immunoglobulin production. Two further children, one with a form of combined immunodeficiency and the other with a T cell defect and extensive cutaneous herpes simplex infection, showed benefit from therapy though in the latter we could not demonstrate that this was important in clearing the virus infection. None of the other children showed any consistent improvement either clinically or on testing. We found no evidence of toxicity, allergy or other adverse effects of therapy.

Effect of the thymic factor, thymostimulin (TP-1), on the survival rate of tumor-bearing mice

The effect of treatment with the thymic factor thymostimulin (TP-1) on the survival rate of tumor-bearing mice was studied, using C57BL/6 mice inoculated with 1 x 10(5) Lewis lung carcinoma (3LL) cells. TP-1 given from inoculation day (4 mg/kg, twice weekly) caused a delay in the appearance of primary tumor [14.4 +/- 1.1 (S.E.) days in control; 18.5 +/- 1.4 days in TP-1-treated animals; p less than 0.05], without changing ultimate survival rate. When primary tumor was resected, the incidence of fatal lung metastasis increased as a function of tumor size on resection day. TP-1 given after resection (same dose schedule) significantly increased survival rate as compared to resection only, provided that resected tumor diameter was less than 1.7 mm. The combination of TP-1 and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU; single i.p. injection, 50 mg/kg) was effective in either resected or nonresected primary tumor. Without resection, TP-1 with CCNU cured (more than 6 months free of tumor; untreated animals died within 30 to 44 days) 55% of the animals, as compared to 23% cured by CCNU alone (p less than 0.01). With resection animal cure rates were: resection (resected tumor diameter, 0.7 to 1.7 mm) alone, 42% cured; resection with CCNU, 47% cured; resection with TP-1, 70% cured; resection with CCNU and TP-1, 100% cured (last two groups significantly different from resection only). The results indicate a profound effect of TP-1 in prolonging life and increasing cure of tumor-bearing mice. This effect was manifested when tumor load was small and was apparently more pronounced on metastatic than on primary tumor.

[Correction of the T immunological system deficit in experimental and clinical tuberculosis]

Thymus grafts, in semi-permeable chambers, from 7-10 day old white rats to guinea-pigs infected with M. tuberculosis, or to white rats that had underwent thymectomy and had been infected, is accompanied by a considerable decrease in the severity of the tuberculous process. A similar effect is obtained by the subcutaneous injection of a thymus preparation called Timalin. The addition to etiotropic therapy of the immunostimulant Levamisole in amounts of 2,5 mg/kg of body weight in white rats, and of 25 mg/kg of body weight in guinea-pigs, three times during a decade significantly enhanced the effect of the conventional therapy. Levamisole, when included in the complex therapy of tuberculosis patients (three times during a decade), accelerated the detoxification process, and the recovery of recent destructive lesions in the lung. In animals and in patients Levamisole increases the low activity of the T-lymphocytes immune system, as is indicated by data obtained with the leucocyte migration inhibition test, and with the rosette-formation test.

Histiocytosis-X

Twelve of 17 patients with histiocytosis-X were immunologically abnormal, as shown by the presence of circulating lymphocytes spontaneously cytotoxic to cultured human fibroblasts or of antibody to autologous erythrocytes. The patients also had a notable lack of histamine H2 surface receptors on their T lymphocytes, suggesting a suppressor-cell deficiency. The lymphocyte abnormalities were reversed in vitro after incubation in a crude extract of calf thymus gland, and therefore all 17 patients were treated with daily intramuscular injections of this extract. With this therapy, 10 patients entered complete remission -- a response at least as good as that observed in historical controls treated with chemotherapy. A positive clinical response was associated with an increase in the number of T-cell histamine H2 receptors to normal levels and with correction of the other immunologic abnormalities. The results of this preliminary study justify a larger prospective clinical trial of thymic extract and further investigation of the immunoregulatory mechanisms in histiocytosis-X.

Clinical impressions on the treatment of multiple sclerosis with thymus factor

Nonspecific stimulation either with unfractionated thymus factor (TF) or fractions IV and VIII of TF was carried out in 13 patients with clinically definite multiple sclerosis (MS). Thymus hormones were given in a daily dose of 10 mg from 1 to 14 months. Three patients became non-tolerant to TF and were undergoing the treatment with TF IV or TF VIII. After immunostimulation 8 remained unchanged, 2 slowly improved (by one degree in Kurtzke's scale), 2 markedly worsened and 1 died. Five patients suffered 8 relapses, 3 showed slow progression and 2 developed either acute nephropyelitis or periodontitis. During this brief therapy, no convincing conclusion may be drawn regarding the effect upon the clinical course, although there is suggestion that thymus factor does not abolish the relapses in multiple sclerosis.

Immunologic and clinical investigation on a bovine thymic extract. Therapeutic applications in primary immunoedificiencies

Thirteen patients with primary immunodeficiencies (eight with T-cell deficiency, one with Wiskott-Aldrich (W-A) syndrome, two with common variable agammaglobulinemia (CVA), and two with severe combined immunodeficiency (SCID) were treated with a calf thymus extract, called thymostimulin (TS). It has been shown that this extract causes in vitro differentiation of T-cell precursors in patients with T-cell defect. Five of eight patients with pure T-cell defect showed immunologic recovery and clinical remission lasting for several months after interruption of the therapy; one had only transient reconstitution, one had slight increase in T-cells (clinical conditions not yet estimated), and two patients soon died from severe infections after showing a slight increase of T-cells. Immune recovery was assess by an increase of the absolute number of E-rosettes forming cells, of human T-lymphocyte antigen positive cells and of PHA responsiveness in the peripheral blood, and by a positive delayed hypersensitivity reaction to antigens. In five patients, there was also B-cell increase after TS treatment. Clinical remission consisted of disappearance of infections, weight gain, and in improvement in general conditions. No effect was observed in one patient with W-A syndrome, in two with CVA, and in two with SCID. Several hypotheses on the mechanisms involved in immune reconstitution are discussed. It seems likely that TS acts on prethymic cells or on the epithelial cells of hypoplastic thymuses. TS was not effective, either in vitro or in vivo, in patients with SCID probably because of a defect in stem cells.

Effect of tissue specific mitotic inhibitors on survival time of spontaneous and virus-induced murine leukaemia and influence on myocardial degeneration

Treatment of adult AKR mice with tissue-specific mitotic inhibitor mol. wt. 1,000--20,000 extracted from the AKR thymus significantly delayed the onset of spontaneous thymus leukaemia, whereas extracts of other organs were without effect. A slight prolongation of survival time was found with spleen extract when administered to BALB/c mice infected with Rauscher virus, which causes leukaemia starting in the spleen. Thymus extracts of MW 100,000--300,000 caused myocardial degeneration in some leukaemic and nonleukaemic mice.

Study of thymic factors. II. Failure of thymosin to alter the natural history of NZB and NZB/NZW mice

The effects of daily injections of thymosin, bovine fraction V, on the natural history of NZB and NZB/NZW F1 mice were investigated. With the use of several dose schedules, no significant differences were discovered in treated versus control groups when survival, autoantibodies, and mitogen responsiveness were compared. These results provide further evidence that thymosin may have little or no role in the treatment of the autoimmune disease of New Zealand mice. More encouraging research in thymic extracts and their measurement is necessary before clinical trials in SLE are considered.

Thymosin restores T cell function and reduces the incidence of amyloid disease in casein-treated mice

Evidence is presented that T cell impairment appears to be specifically related to the pathogenesis of experimental amyloidosis. This conclusion is based on the finding that thymosin administration improves T cell function as measured by mitogen stimulation of spleen cell suspension and at the same time reduces the incidence and severity of amyloid disease in casein-treated mice.

Immunological and patho-clinical observations of a patient with rectal carcinoma after long term administration of thymic extract (TFX)

TFX (Thymus Factor X) extract from calf thymuses, was given for the first time in Poland to the patient suffering from advanced rectal cancer with perforation to the peritoneal cavity, diffuse fecal peritonitis and multiple metastases to the liver. The immunological, clinical and histopathological observations of the patient for the period of 12 months of treatment are presented. The patient was given the biologically active thymus extract in the total amount of 14.2 mg in 34 subcutaneous injections initially in single dose of 0.1 mg and later on in amount of 0.5 mg. The remarkable restoration of the immunological reactivity of the patient from a total energy to the state of hyperreactivity has to be emphasized. It has been confirmed by the delayed hypersensitivity skin tests (Rt-23, PHA), the increase of the number of RFC (TEa and TEt rosette test with the SRBC), the diminishing of the autolymphocytotoxicity of the peripheral lymphocytes (evaluated by DTL) and also by the high level of the absolute number of circulating lymphocytes in the peripheral blood. The improvement of the clinical condition of the patient consisted in total regression of the inflammatory and functional changes in the respiratory and cardiovascular systems and also in the renal function. The regular rectal endoscopic examinations of the patient revealed the diminished size of the tumor and its unusual appearance described as an induration and sharp delimitation from the surrounding tissues. The histological examinations performed 5 times during the observation period of 11 months revaled the essential changes in the structure of the growth: the marked increase of the stroma with the signs of active proliferation, foci calcification and ossification. These changes were interpreted as extremely rare in the rectal cancer stroma and are considered to represent dystrophic calcification at the neoplastic foci followed by ossification. It should be also pointed out that twelve months survival of the patient with advanced rectal cancer and multiple metastases to the liver represents an unusually long rate in comparison to that generally accepted in the literature for this grade of rectal cancer advancement.

Initial observations on the administration of thymus extract (TFX) in patients with alimentary tract neoplasms

The administration of thymus extract (TFX) has been performed in 35 patients suffering from malignancies of the alimentary tract. TFX, being a calf thymuses extract prepared by Jelenia Góra Drug Producers "Polfa" was given in the dose of 0.5 mg in 3 or 7-day intervals during several months. The immunological condition of patients was checked by many tests: E-rosettes, DLT (direct lymphocytotoxicity test) determination of absolute number of peripheral blood lymphocytes and skin tests (RT-23, PHA and TFX). Our observations revealed that TFX is biologically active also in humans, increases cell-mediated immunity and may restore the immune capability of patients operated due to malignancies of the alimentary tract.

Regulation of immune balance by thymosin: potential role in the development of suppressor T-cells

Studies in a variety of animal and human models indicate that thymosin plays a role in the differentiation of a number of T-cell subpopulations. The hypothesis presented is that a normal immune balance depends heavily upon the presence of thymosin-activated suppressor or regulator T-cells. A major thrust in our present research program is to determine whether or not the various disorders discussed here are causally related to abnormal thymosin production by the thymus gland. We are also assessing in animal models the potential value of thymsin in the treatment of specific autoimmune diseases. This information may yield new insights for the management of autoimmune type disorders such as SLE. Results from clinical trials to date suggest that thymosin will have a role in boosting the immune responses of patients with specific thymic malfunctions and may indeed exert an influence via the production of suppressor or regulator T-cells.

Thymosin-induced reduction of "null cells" in peripheral-blood lymphocytes of patients with systemic lupus erythematosus

Although thymosin, a thymic hormone, has been shown to restore cellular immunity in NZB/NZW mice, its effect in human systemic lupus erythematosus (S.L.E.) and other auto-immune disorders has not been tested. The present study shows for the first time that the proportion of "null cells" in peripheral-blood lymphocytes of patients with active S.L.E. is significantly decreased after in-vitro thymosin treatment. Thymosin has no effect on the percentages of T cells, B cells, and "null" cells in peripheral-blood lymphocytes from normal controls and patients with inactive S.L.E. and active rheumatoid arthritis. These findings suggest that thymosin may play an important part in the pathogenesis and treatment of this condition.

Thymosin activity in patients with cellular immunodeficiency

An extract of calf thymus, thymosin, induces an increase in percentage of T-cell rosettes when incubated in vitro with sheep erythrocytes and lymphocytes from patients with primary immunodeficiency diseases or viral illness. Precursor lymphocytes are required for this increase to occur. The percentage of T-cell rosettes, when they are normal, is not increased further upon incubation with thymosin. A patient with thymic hypoplasia and immunoglobulin synthesis was selected to receive thymosin in vivo when her T-cell rosettes had increased from 15 to 48 per cent after in vitro incubation with thymosin. During therapy, she clinically improved, the percentage of T-cell rosettes gradually increased to normal, and positive delayed hypersensitivity skin tests developed. Thymosin may be useful clinically for partial reconstitution of cellular immunity. An increased percentage of T-cell rosettes after incubation with thymosin in vitro may predict which patients will respond to thymosin therapy in vivo.