Human tumor immunology

Hemochromatosis as a secondary condition to systemic lupus erythematosus: A case report

Systemic lupus erythematosus (SLE) is an autoimmune disorder that affects multiple organs and systems, including joints, the cardiovascular system, lungs, skin, kidneys, the nervous system, and blood. The clinical presentations of SLE are diverse and vary widely. In this report, we present a case of a patient whose SLE was complicated by hemochromatosis to enhance clinicians' comprehension of this infrequent or rare complication of SLE. We aim to provide insights into the diagnosis and treatment processes of this condition.

The hemochromatosis protein HFE 20 years later: An emerging role in antigen presentation and in the immune system

Introduction

Since its discovery, the hemochromatosis protein HFE has been primarily defined by its role in iron metabolism and homeostasis, and its involvement in the genetic disease termed hereditary hemochromatosis (HH). While HH patients are typically afflicted by dysregulated iron levels, many are also affected by several immune defects and increased incidence of autoimmune diseases that have thereby implicated HFE in the immune response. Growing evidence has supported an immunological role for HFE with recent studies describing HFE specifically as it relates to MHC I antigen presentation.

Methods/Results

Here, we present a comprehensive overview of the relationship between iron metabolism, HFE, and the immune system to better understand the origin and cause of immune defects in HH patients. We further describe the role of HFE in MHC I antigen presentation and its potential to impair autoimmune responses in homeostatic conditions, a mechanism which may be exploited by tumors to evade immune surveillance.

Conclusion

Overall, this increased understanding of the role of HFE in the immune response sets the stage for better treatment and management of HH and other iron‐related diseases, as well as of the immune defects related to this condition.

Ovarian cancer and gangrene of the digits: case report and review of the literature

Digital ischemia has been reported with various types of cancer, especially gastrointestinal. It is more common in elderly women than in any other group, and the most common symptom is a gangrenous finger (or fingers). More than half of the patients have metastatic involvement. Once the primary disease has been treated, when feasible, the digital symptoms usually regress or disappear. The presence of digital ischemia without other rheumatologic stigmata or vascular predisposition in an elderly patient should raise clinical suspicion of a paraneoplastic phenomenon. Herein we describe a 65-year old woman with digital ischemia associated with ovarian cancer. The diagnosis was established by biopsy after extremely high levels of cancer antigen 125 were detected.

Adaptation of anticancer strategies to progress in tumor immunology

The numerical development of cancer cells during tumor growth and under current forms of therapy is quantitatively described as a fundamental of a scientifically founded anticancer strategy. As to general cancer prevention, suppression of metastasis and reduction of recurrencies, figures are derived, which allow one to assess the minimal number of malignant cells to be killed. The killing potency of current tumor-immunological measures has not so far been sufficient enough to have a good chance of achieving these ambitious goals. The main reason for this is the neglect of the oxygen status of the body and its dynamics. This is a surprising fact, since all immunological mechanisms are known to be energy-, i.e., oxygen-dependent. The experimentally confirmed correlation between the effectiveness of body defense and the quality of the oxygen status was the origin of several variants of the oxygen multistep immunostimulation concept (application of immunostimulators combined with the oxygen multistep therapy). Clinical results reflect the remarkable increase of cell-killing potency achievable by these measures and give reasons for the adaptation of anticancer strategies to progress in tumor immunology. Furthermore, real methodological proposals are made for general cancer prevention, suppression of metastasis, and reduction of recurrences, and the concept of a combined therapy is developed. This therapy comprises the currently accepted measures, such as surgery, irradiation and drugs, and the adjuvant O2 multistep immunostimulation, which is applied threefold according to a particular schedule. The advantage of this combination is that the patient comes first into the enjoyment of all the beneficial effects that established regimens can offer for the particular case. Then and moreover, the patient gains better quality of life, because the adverse side-effects of radiation and drugs are attenuated and, finally, the individual gets a fair chance of stopping the progression of the disease.

Humoral immune response in melanoma and glioma patients: a solubilized melanoma-membrane component as a tool for detecting circulating antibodies

In search of tumor-associated components in human melanomas and gliomas, plasma membranes were isolated from these tumors and compared morphologically, biochemically and immunologically with those from normal human brain. The preparations exhibited a comparable ultrastructure of empty vesicles of various form and size. The melanoma membrane consisted of at least 15 protein components and the glioma membrane consisted of at least 24 protein components, four of which were absent in the membrane of normal tissue, as revealed by polyacrylamide gel electrophoresis. The four tumor-associated polypeptides could be solubilized together with a few other membrane components by the non-ionic detergent Triton-X100 and were used as an antigen source for immunologic characterization of melanoma and glioma membranes. A rabbit antiserum prepared against these solubilized membrane components from melanoma were absorbed with plasma membranes from a variety of normal tissue including erythrocytes, lymphocytes, spleen, liver, lung, kidney, placenta and brain. The absorbed antiserum reacted with the membrane extract of all the 11 melanomas tested so far; in addition it cross-reacted with an identically prepared extract from all the 15 gliomas tested. Membrane extracts from other tumors, such as kidney and mammary carcinoma, were negative in this respect. Furthermore, a rabbit antiserum prepared against Triton extract from glioma membranes yielded after exhaustive absorption an immune precipitate not only with the specimens from the 15 other gliomas but also with those from the 11 melanomas. Electrophoretic analysis of the immune precipitate formed by the immunoglobulin fraction of the absorbed rabbit antiserum and the Triton-X100 extract from melanoma membranes exhibited six polypeptide bands, two of which appear antigen-derived as they were missing in the profile of the immunoglobulin pattern. A comparable electrophoretic pattern was obtained with the immune precipitate of the glioma antigen specimen. The molecular weight of these two polypeptides was estimated on the basis of their electrophoretic mobility to be 55,000 and 10,000 daltons, respectively. The electrophoretic immunologic findings argue for a common membrane component in human melanoma and glioma patients. Using the Triton extract from melanoma membranes as an antigen source, precipitating antibodies could be detected in the immunoglobulin fraction of 16 of the 24 sera from melanoma patients and in that of 15 of the 23 glioma patients by means of counter-current electrophoresis. Sera from a variety of cancer patients with diseases other than melanoma or glioma as well as from patients without cancer were negative in this respect.

Humoral immune response in glioma patients: A solubilized glioma-associated membrane antigen as a tool for detecting circulating antibodies

Plasma membranes from normal and neoplastic human brain tissue were isolated and compared morphologically, biochemically and immunologically. There ultrastructure was identical, electrophoresis on polyacrylamide gel revealed at least 24 protein components, four of which were absent from membranes of normal tissue, whereas one was missing in the tumor pattern. The tumor-associated components could be solubilized by the non-ionic detergent Triton-X100 and were used as an antigen source for the immunological characterization of glioma membranes. By means of a rabbit antiserum immunologically identical components could be detected in the Triton extract of the membranes from all the 20 human gliomas tested so far, but not in normal or fetal brain, nor in liver, kidney or spleen tissue. These data indicate that the solubilized membrane components contain common glioma-associated membrane antigens which might be used in the detection of circulating antibodies in the sera of glioma patients. Of the 24 samples of sera tested so far, 19 (79%) contained precipitating antibodies against these membrane components as revealed by countercurrent electrophoresis.

Immunobiology of head and neck cancer: basic concepts

Patients with squamous cancer of the head and neck have unique perturbations of the immune system. These patients have marked depression of cellular immunity even in the early stages of disease. The known facts about the immunobiology and the immunodeficiencies that commonly occur are discussed. Also reviewed are the relationships of the immunologic deficits to stage of disease, to prognosis, and to the suspected etiologic factors of smoking, alcoholism, and malnutrition. Highlights are given of current immunotherapeutic trials. To date, most of the successful efforts in both immunologic research and immunotherapy of head and neck cancer have dealt with general, rather than specific, immune reactions. Further development in the area of specific immune responses may permit more meaningful measurements of tumor-specific reactions, thus yielding useful tools for immunodiagnosis as well as providing more effective and precise methods of immunotherapy.

The effect of dinitrochlorobenzene (DNCB) on dimethylbenzathracene (DMBA) carcinogenesis on hamster buccal pouch

DNCB is an antigen that stimulates the cell-mediated response in a sensitized host. The purpose of this study was to define the effect DNCB would have on a standard model system for oral carcinogenesis, theorizing that tumorgenesis would be delayed or inhibited. Fifty-six Syrian hamsters were divided into four groups. In group A (DNCB/DMBA), the right buccal pouch of twenty animals was treated with 2% DNCB in orabase, twice a week, and 0.5% DMBA, three times a week, for 10 weeks. In group B, twenty animals received DMBA only. In group C, six animals received DMBA in Orabase. In group D, ten animals received DNCB in Orabase only. The animals were killed at 6, 12, 16, and 20 weeks. The results indicate that there were no differences in the latent period or in the histologic characteristics of the epidermoid carcinomas that developed. However, there was sensitization of the buccal pouch in pouches painted with DNCB, in that gross and histologic evidence of a delayed sensitivity reaction was demonstrated.

Transfer of tumor-specific immunity with syngeneic spleen cells and serum from mice that have large tumors and metastases

Experiments were designed to assess 1) relative immunity after adoptive transfer of spleen cells or serum from tumor-bearing mice to untreated syngeneic mice, and 2) the degree of tumor-specific transplantation immunity imparted by cells or serum relative to tumor size and the presence of metastases in the donor at the time of spleen cell or serum transfer or after in situ necrosis of the primary tumor by cryosurgery in a CDF1-sarcoma system. Viable lymphoid spleen cells or serum from normal mice had no effect on tumor growth. Serum from mice that had large tumors and gross metastases induced a protective effect similar to that found after cryosurgery of the primary tumor. Serum from mice with small tumors and spleen cells from animals bearing either small or large tumors failed to induce immunity consistently. In no instance did serum from tumor-bearing mice induce enhancement of tumor growth.

Influence of different cytotoxic drugs on T and B lymphocytes in children with all during remission maintenance therapy

The influence of four different cytotoxic drugs (MTX, CYC, 6MP, and ARA-C) on T, B, and O-lymphocytes was investigated in 20 children with ALL in complete remission during cyclic remission maintenance therapy. Each of the four drugs causes a marked reduction of the absolute number of T and B cells whereas the relative number lies within the normal range with the exception of CYC, which leads to a depression of the percentage of both T and B cells. The percentage of O cells is markedly increased by CYC and slightly increased by MTX, 6MP, and ARA-C. The data are interpreted with care since the function of the immune system and especially tumor rejection depends on the interaction between the different lymphocyte subpopulations.

Transfer of tumor specific immunity with "immune" RNA: prospects for the treatment of human cancer

Ribonucleic acids extracted from specifically sensitized lymphoid cells (I-RNA) have been shown to transfer specific immunoreactivity to normal non-immune lymphoid cells. Evidence for the transfer by I-RNA, of immune responses to tumor-associated antigens of animal and human neoplasms, in vivo and in vitro, is reviewed. Results obtained in our laboratory and in other laboratories indicate that xenogeneic, allogeneic and syngeneic I-RNA extracts mediate specific cytotoxicity to tumor cells, in vitro, and mediate transplantation resistance and tumor rejection responses in vivo. Our results suggest that I-RNA preparations fail to elicit immune responses directed against "self" antigens. By contrast, I-RNA's directed against "non-self" tumor-associated antigens appear to induce lymphocytes to effect specific anti-tumor immune responses. The mechanisms responsible for the failure of I-RNA to initiate immune responses against "self" antigens are not known at present and demand investigation. Preliminary results of a clinical Phase I trial of immunotherapy with xenogeneic I-RNA in selected cancer patients are reviewed. I-RNA might offer promise as a new modality for the immunotherapy of human cancer.

Immunobiology of human bladder cancer

The immune destruction of bladder cancer most likely results from an interaction of specific and non-specific cellular and humoral responses evoked by tumor-associated antigens. We are just beginning to comprehend the complex immune mechanisms operating to retard or facilitate tumor growth in patients with this disease. This understanding has led to renewed hope that the immune system may be manipulated for the benefit of the tumor-bearing patient. However, only a thorough understanding of the basic functions of the immune system in man will permit a rational approach to immunotherapy in patients with bladder cancer.

Selective and non-selective lymphocytotoxicity in human melanoma: observation on the effect of long-term culture and fetal bovine serum on target-cell sensitivity to lymphocytes

In vitro cell mediated cytotoxicity (CMC) assays have been conducted in a human melanoma system with a 3H-proline retention technique. Melanoma target cells from long-term cultures ("cell lines") are found to exhibit increased susceptibility for lymphocyte cytotoxicity in comparison to the same target cells from short-term culture. The higher sensitivity of the "cell line" derived target cells is seen with lymphocytes, irrespective of diagnosis of the donor. In parallel experiments with the target cells grown in medium supplemented with fetal calf serum (FCS) and AB+ human serum (from a normal male doner), the melanoma target cells grown with FCS do not show any enhanced cytotoxicity, suggesting no causal relationship of such enhanced sensitivity of "cell line"-derived target cells to "heterologous melanoma antigens" that might have been acquired by the target cells following the use of FCS in tissue culture. In controlled assays of in vitro CMC, lymphocytes from melanoma patients (14/44) exhibited selective cytotoxicity (destruction of only one target-cell type) against the melanoma target cells, whereas only 3/97 control lymphocytes (other malignancies and normal donors) showed such melanoma-selective cytotoxicity. This difference is statistically significant at p less than 0.001. Non-selective cytotoxicity (destruction of two or more unrelated target cell types) was seen with lymphocytes from 9/44 melanoma patients, 13/51 patients with other malignancies and 8/46 normal donors. No correlation of selective cytotoxicity could be established with donors' age, sex, stage of disease, therapy or history of blood transfusion. Such a correlation may emerge as our series becomes larger. Despite the lack of any correlation between selective cytotoxicity and disease status, our study reaffirms the existence of selective cytotoxicity by melanoma patients' lymphocytes against melanoma target cells.

Immune response to a syngeneic rat tumour: development of regional node lymphocyte anergy

The development of cellular immunity to a syngeneic squamous cell carcinoma in Wistar rats was studied by in vitro microcytotoxicity assay. Reactivity of lymphocytes from lymph nodes, spleen and blood was tested throughout the period of tumour growth. Maximum lymphocyte cytotoxicity against the tumour was observed at 2 weeks in regional lymph nodes, 4 weeks in intermediate nodes, spleen and blood, and 6 weeks in distant nodes; the intensity of these cytotoxic responses subsequently declined. In the regional nodes, lymphocytes became totally unresponsive despite the maintenance of significant cytotoxicity in intermediate nodes, spleen and blood. Local anergy may account for tumour spread to the regional node in an otherwise immunocompetent host. This anergy may be due to high local concentration of tumour antigen or antigen-antibody complexes, but it was not associated with selective changes in T and B cell proportions.