Immunological Studies of Anergic Patients

Abstract

Sixty-one patients with a variety of different illnesses were studied with respect to skin test anergy and the presence of serum chemotactic inhibitors. In initial testing, 55% of the patient tests demonstrated negative skin test responses to all six test antigens. Sera from 65% of these anergic patients were capable of suppressing the migration of normal polymorphonuclear leukocytes toward chemotactic factors. Statistical analysis of the association of anergy and chemotactic inhibitory sera resulted in a P value of <0.0005. Chemotactic inhibitory sera were also capable of suppressing monocyte chemotaxis. No association of chemotactic inhibitory activity and lymphocytotoxic antibody or suppressors of mitogen-induced lymphocyte blast transformation were noted. In addition, T-cell populations in some anergic patients were studied by the erythrocyte-binding technique. Erythrocyte-binding lymphocytes in anergic patients were significantly suppressed when compared to normal controls, but not when compared to skin test-positive patients. The data presented here indicate a close parallel between skin test anergy and the presence of serum chemotactic inhibitory activity. The exact relationship is yet undefined but may indicate the involvement of chemotactic inhibitors as immunological regulators in the host during a variety of systemic illnesses.

Suppression of leukocyte chemotaxis by human IgA myeloma components.

“…Blood was mixed with heparin, 10 U/ml, to prevent coagulation. Neutrophil preparations were obtained as previously described (2,(5)(6)(7) by Plasmagel sedimentation of erythrocytes and resuspension of leukocytes to a concentration of 7 x 106 PMNs/ml in Hanks' balanced salt solution (HBSS). In some experiments mononuclear cells were removed from these preparations by Ficoll-Hypaque centrifugation (8).…”

“…Studies of PMN chemotaxis were performed using a modified Boyden technique (2,(5)(6)(7). Chemotaxis was expressed as a chemotactic index representing the average number of cells per high power field (400 ×) which had migrated to the distal side of the membrane.…”

Serum chemotactic inhibitory activity: heat activation of chemotactic inhibition

“…No patients studied were receiving corticosteroids or immunosuppressive drugs. Patients were classified as anergic on the basis of skin testing with six antigens including mumps, purified protein derivative, candida, trichophyton, and streptokinase-streptodornase as previously defined (14,15). Skin tests were measured for induration at 24 and 48 h, and the largest diameter seen at either 24 or 48 h was declared the maximal skin test response.…”

“…Serum chemotactic inhibitors have been described in patients with a variety of systemic illnesses (3,4,9,(12)(13)(14)(15)17). In previous reports we have shown the presence in serum of three inhibitors of leukocyte chemotaxis based upon differences in sedimentation behavior (15,16).…”

“…These inhibitors potentially may act either directly upon chemotactic factors as is the case with chemotactic factor inactivator (CFI) (2, 9,13,17) or at the cellular level. Serum chemotactic inhibitory activity (CIA) has been shown to be transient in nature, and in many patients it parallels the presence of skin test anergy (14)(15)(16). These factors appear to resemble acutephase reactants since their appearance is prominent during episodes of acute illness or exacerbations of chronic disease (14-16).…”