Antibody-mediated killing of suppressor T lymphocytes as a possible cause of macroglobulinemia in the tropical splenomegaly syndrome.

Abstract

To investigate the pathogenesis of macroglobulinemia in the tropical splenomegaly syndrome (TSS), we assessed the functional activity of B lymphocytes and T cell subsets in a pokeweed mitogen-driven assay of immunoglobulin synthesis. Mononuclear cells from patients with TSS produced more IgM than cells from village or from distant controls. This appeared to result from a decrease in the number and/or activity of suppressor T cells of the T8S phenotype. The lack of functional suppressor T lymphocytes was associated with the presence in sera from patients with TSS of IgM antibodies that specifically killed T8+, 9.3-, 60.1+ T cells from normal donors. These results support the hypothesis that macroglobulinemia in TSS results from defective immunoregulatory control of B cell function, and that this may be caused by lysis of suppressor T cells by specific lymphocytotoxic antibodies produced by patients with this syndrome.

Hyper-reactive malarial splenomegaly: Rare cause of pyrexia of unknown origin

“…This leads to anemia, deposition of large immune complexes in kupffer cells in liver and spleen, reticuloendothelial cell hyperplasia, and hepatosplenomegaly. 2,3,8 HMS is usually associated with a high mortality rate. Overwhelming infections are a the leading cause of death.…”

Splénomégalie palustre hyper-réactive

“…Une équipe a proposé une explication au défaut de lymphocytes T suppresseurs par l'apparition d'autoanticorps dirigés contre ces cellules au cours de l'infection palustre [19][20][21].…”

Malaria

“…The pathophysiology of HMS involves an overproduction of polyclonal IgM in response to repeated infections with P. falciparum, P. malariae or P. vivax. This appears to be due to a depletion of suppressor T cells, leading to a lack of inhibition of B cell activity and failure of maturation of the immune response to IgG production (Piessens et al, 1985;Bates et al, 1991). HMS and splenic lymphoma with villous lymphocytes are clinically indistinguishable and appear to be aetiologically related (Bates and Bedu-Addo, 1997).…”