1247 response between levamisole treated and untreated
lymphocyte interpreted as a positive effect by levamisole. In the accompanying table an augmentating effect by levamisole is shown in relation to the P.H.A. responsiveness state of lymphocytes from subjects in the 4 groups, and in all 63 subjects. It can be seen that in 5 (14%) of 37 subjects whose lymphocytes showed a normal response levamisole augmented the response. Of the 26 subjects showing P.H.A. hyporesponsiveness, lymphocyte response was augmented in 18 (69%). This difference was Levamisole statistically significant (x2=20.5; p< 0-001). treatment restored P.H.A. responsiveness to within the normal range in 11 (61%) of these 18 P.H.A. hyporesponsive subjects. An inhibitory effect was observed in 3 (5%) of the 63 subjects. All 3 (2 P.T.B., 1 N.P.C.) were normoresponsive to P.H.A. cultures
.
in-vitro action of levamisole which are hyporesponsive to P.H.A. are used as target cells. This culture system might be suitable as an in-vitro assay of the lymphoThe culture cyte augmenting effect of levamisole. system may also be useful in elucidating the mechanism of P.H.A. hyporesponsiveness in that an augmenting effect indicates that r.H.A.-responsive cells are present and that their responsiveness can be at least partly restored.
is
-
was
The results indicate that more pronounced when
an
lymphocytes
Department of Pathology,
University
of
Singapore.
S. H. CHAN.
W.H.O. Immunology Research and
Training Centre, University of Singapore, McAlister Road,
Singapore
3.
M. J. SIMONS.
NORMAL RECIRCULATION OF T LYMPHOCYTES IN CHRONIC LYMPHOCYTIC LEUKÆMIA
per hour in the
peripheral lymph was calculated by multiplying lymphocyte concentration by the hourly lymph flow. Spontaneous rosette formation with sheep erythro° its
cytes
used
as a
T-cell marker. 4,6
hourly output of peripheral lymph was within the normal range in the c.L.L. patients. The normal migration of T lymphocytes from blood to lymph suggests a normal recirculation of these cells in patients with C.L.L. This finding indicates that the T cells in c.L.L. represent a normally functioning lymphocyte population. This interpretation is further supported by the normal cell-mediated immunity as assessed in vivo by positive skin-test reactivity to bacterial and fungal antigens in the patients studied. The almost complete absence of B cells in the peripheral lymph confirms the data of Engeset et a1. and our previous findings of impaired recirculation of B-cell-like c.L.L. lymphocytes 9,10 and is in agreement with recent animal studies showing a slower and reduced recirculation of B cells compared with T cells.11,12 This work was supported by the Deutsche Forschungsgemeinschaft, the Alfred and Clare-Pott-Stiftung, and the Ministerium fur Wissenschaft und
Forschung, Nordrhein-Westfalen. K. BREMER
SIR,-In chronic lymphocytic leukxmia (C.L.L.) monoclonal B cells proliferate and accumulate, 1, leaving only small percentages of T cells.3,4 However, absolute reveals normal or even increased numbers of T cells in the blood of patients with C.L.L., and the findings by Dr Catovsky and his colleagues (Sept. 28, p. 751) suggest that increased numbers of circulating T cells are associated with a more stable C.L.L. disease process. To further elucidate the in-vivo functional capacity of T cells in c.L.L., we studied their ability to migrate from blood to
was
As shown in the accompanying table, the percentage of T cells was diminished in the blood of the C.L.L. patients compared with that in the hasmatologically normal controls, whereas the majority (82-98%) of the c.L.L. cells had B-cell surface charac.teristics-e.g., membrane-bound immunoglobulins. In contrast, the peripheral lymph of the C.L.L. patients and the controls contained 72-89 % T cells and no or only few B cells (0-2%). 2 of the c.L.L. patients had increased absolute numbers of T cells both in blood and peripheral lymph. Furthermore, the ratio between the numbers of T cells per ml. blood and those in the
Division of Hæmatology, Department of Medicine, University of Essen,
Essen, Germany.
G. COHNEN W. AUGENER G. BRITTINGER.
measurement
lymph. hsmatologically normal patients (blood-lymphocyte 1500-2000 per c.mm.) and 3 patients with C.L.L. (blood-lymphocyte counts 20,000-130,000 per c.mm.) a peripheral lymph vessel in the lower leg was cannulated to collect prenodal afferent lymph.5 The lymphocyte output In 4
counts
PHAGOCYTOSIS IN CHRONIC GRANULOMATOUS DISEASE SIR,--We should like to comment on the phagocytosis experiments in chronic granulomatous disease reported by Dr Biggar (May 3, p. 991), which has led to the conclusion of an increased phagocytosis of C.G.D. leucocytes. The differences found between the number of viable bacteria in c.G.D. leucocytes and control leucocytes in his 6. 7.
Preud’homme, J. L., Seligmann, M. Blood, 1972, 40, 777. Aisenberg, A. C., Bloch, K. J. New Engl. J. Med. 1972, 287, 272. 3. Brown, G., Greaves, M. F., Lister, T. A., Rapson, N., Papamichail, M. Lancet, 1974, ii, 753. 4. Cohnen, G., Augener, W., Buka, A., Brittinger, G. Acta hœmat. Basel, 1974, 51, 65. 5. Engeset, A., Hager, B., Nesheim, A., Kolbenstvedt, A. Lymphology, 1973, 6, 1.
1. 2.
Jondal, M., Holm, G., Wigzell, H. J. exp. Med. 1972, 136, 207. Augener, W., Cohnen, G., Brittinger, G. Biomed. Express, 1974, 21,
6. 8. Engeset, A., Fröland, S. S., Bremer, K., Scand. J. Hœmat. 1974, 13, 93. 9. Bremer, K., Wack, O., Schick, P. Biomedicine, 1973, 18, 393. 10. Flad, H. D., Huber, Ch., Bremer, K., Menne, H. D., Huber, H. Eur. J. Immunol. 1973, 3, 688. 11. Sprent, J., Miller, J. F. A. ibid. 1972, 2, 384. 12. Howard, J. C. J. exp. Med. 1972, 135, 185.
T LYMPHOCYTES IN BLOOD AND PERIPHERAL LYMPH OF PATIENTS WITH C.L.L. AND HÆMATOLOGICALLY NORMAL PATIENTS
(CONTROLS)
lymphocyte interpreted as a positive effect by levamisole. In the accompanying table an augmentating effect by levamisole is shown in relation to the P.H.A. responsiveness state of lymphocytes from subjects in the 4 groups, and in all 63 subjects. It can be seen that in 5 (14%) of 37 subjects whose lymphocytes showed a normal response levamisole augmented the response. Of the 26 subjects showing P.H.A. hyporesponsiveness, lymphocyte response was augmented in 18 (69%). This difference was Levamisole statistically significant (x2=20.5; p< 0-001). treatment restored P.H.A. responsiveness to within the normal range in 11 (61%) of these 18 P.H.A. hyporesponsive subjects. An inhibitory effect was observed in 3 (5%) of the 63 subjects. All 3 (2 P.T.B., 1 N.P.C.) were normoresponsive to P.H.A. cultures
.
in-vitro action of levamisole which are hyporesponsive to P.H.A. are used as target cells. This culture system might be suitable as an in-vitro assay of the lymphoThe culture cyte augmenting effect of levamisole. system may also be useful in elucidating the mechanism of P.H.A. hyporesponsiveness in that an augmenting effect indicates that r.H.A.-responsive cells are present and that their responsiveness can be at least partly restored.
is
-
was
The results indicate that more pronounced when
an
lymphocytes
Department of Pathology,
University
of
Singapore.
S. H. CHAN.
W.H.O. Immunology Research and
Training Centre, University of Singapore, McAlister Road,
Singapore
3.
M. J. SIMONS.
NORMAL RECIRCULATION OF T LYMPHOCYTES IN CHRONIC LYMPHOCYTIC LEUKÆMIA
per hour in the
peripheral lymph was calculated by multiplying lymphocyte concentration by the hourly lymph flow. Spontaneous rosette formation with sheep erythro° its
cytes
used
as a
T-cell marker. 4,6
hourly output of peripheral lymph was within the normal range in the c.L.L. patients. The normal migration of T lymphocytes from blood to lymph suggests a normal recirculation of these cells in patients with C.L.L. This finding indicates that the T cells in c.L.L. represent a normally functioning lymphocyte population. This interpretation is further supported by the normal cell-mediated immunity as assessed in vivo by positive skin-test reactivity to bacterial and fungal antigens in the patients studied. The almost complete absence of B cells in the peripheral lymph confirms the data of Engeset et a1. and our previous findings of impaired recirculation of B-cell-like c.L.L. lymphocytes 9,10 and is in agreement with recent animal studies showing a slower and reduced recirculation of B cells compared with T cells.11,12 This work was supported by the Deutsche Forschungsgemeinschaft, the Alfred and Clare-Pott-Stiftung, and the Ministerium fur Wissenschaft und
Forschung, Nordrhein-Westfalen. K. BREMER
SIR,-In chronic lymphocytic leukxmia (C.L.L.) monoclonal B cells proliferate and accumulate, 1, leaving only small percentages of T cells.3,4 However, absolute reveals normal or even increased numbers of T cells in the blood of patients with C.L.L., and the findings by Dr Catovsky and his colleagues (Sept. 28, p. 751) suggest that increased numbers of circulating T cells are associated with a more stable C.L.L. disease process. To further elucidate the in-vivo functional capacity of T cells in c.L.L., we studied their ability to migrate from blood to
was
As shown in the accompanying table, the percentage of T cells was diminished in the blood of the C.L.L. patients compared with that in the hasmatologically normal controls, whereas the majority (82-98%) of the c.L.L. cells had B-cell surface charac.teristics-e.g., membrane-bound immunoglobulins. In contrast, the peripheral lymph of the C.L.L. patients and the controls contained 72-89 % T cells and no or only few B cells (0-2%). 2 of the c.L.L. patients had increased absolute numbers of T cells both in blood and peripheral lymph. Furthermore, the ratio between the numbers of T cells per ml. blood and those in the
Division of Hæmatology, Department of Medicine, University of Essen,
Essen, Germany.
G. COHNEN W. AUGENER G. BRITTINGER.
measurement
lymph. hsmatologically normal patients (blood-lymphocyte 1500-2000 per c.mm.) and 3 patients with C.L.L. (blood-lymphocyte counts 20,000-130,000 per c.mm.) a peripheral lymph vessel in the lower leg was cannulated to collect prenodal afferent lymph.5 The lymphocyte output In 4
counts
PHAGOCYTOSIS IN CHRONIC GRANULOMATOUS DISEASE SIR,--We should like to comment on the phagocytosis experiments in chronic granulomatous disease reported by Dr Biggar (May 3, p. 991), which has led to the conclusion of an increased phagocytosis of C.G.D. leucocytes. The differences found between the number of viable bacteria in c.G.D. leucocytes and control leucocytes in his 6. 7.
Preud’homme, J. L., Seligmann, M. Blood, 1972, 40, 777. Aisenberg, A. C., Bloch, K. J. New Engl. J. Med. 1972, 287, 272. 3. Brown, G., Greaves, M. F., Lister, T. A., Rapson, N., Papamichail, M. Lancet, 1974, ii, 753. 4. Cohnen, G., Augener, W., Buka, A., Brittinger, G. Acta hœmat. Basel, 1974, 51, 65. 5. Engeset, A., Hager, B., Nesheim, A., Kolbenstvedt, A. Lymphology, 1973, 6, 1.
1. 2.
Jondal, M., Holm, G., Wigzell, H. J. exp. Med. 1972, 136, 207. Augener, W., Cohnen, G., Brittinger, G. Biomed. Express, 1974, 21,
6. 8. Engeset, A., Fröland, S. S., Bremer, K., Scand. J. Hœmat. 1974, 13, 93. 9. Bremer, K., Wack, O., Schick, P. Biomedicine, 1973, 18, 393. 10. Flad, H. D., Huber, Ch., Bremer, K., Menne, H. D., Huber, H. Eur. J. Immunol. 1973, 3, 688. 11. Sprent, J., Miller, J. F. A. ibid. 1972, 2, 384. 12. Howard, J. C. J. exp. Med. 1972, 135, 185.
T LYMPHOCYTES IN BLOOD AND PERIPHERAL LYMPH OF PATIENTS WITH C.L.L. AND HÆMATOLOGICALLY NORMAL PATIENTS
(CONTROLS)
