Summary
Using a reverse hemolytic plaque assay as the effector system, we studied in vitro B-lymphocyte function in 12 patients after posttraumatic splenectomy as well as in 25 normal individuals. The time interval between the splenectomy and the immunological studies varied between 2 days and 7 years. Compared to normal individuals, the splenectomized patients had markedly elevated numbers of spontaneous immunoglobulin-secreting cells and severely decreased responses to the polyclonal activator pokeweed mitogen, indicating an in vivo polyclonal B-cell activation. A tendency towards normalization of these abnormalities, especially the high spontaneous ISC levels, could be observed during the time interval extending up to 7 years after splenectomy. In order to characterize the mechanism responsible for the altered immune response in splenectomized patients, in vitro experiments were performed with separated lymphocytes. These revealed an impaired T-helper cell capacity as well as an intrinsic B-cell defect. Marker analyses with monoclonal antibodies revealed normal proportions with the exception of OKT 4 positive and B 1 positive cells that identify T-helper/inducer and peripheral B-cells, respectively. We conclude that immune dysfunction in peripheral blood lymphocytes of splenectomized patients involves mainly the OKT 4 positive cell population.
Zusammenfassung
Bei 12 Patienten, die wegen traumatischer Schädigung der Milz splenektomiert worden waren, und bei 25 Normalpersonen wurde in vitro mit Hilfe eines reversen hämolytischen Plaque Tests das humorale Immunsystem untersucht. Das Zeitintervall zwischen Milzexstirpation und immunologischer Untersuchung betrug 2 Tage bis 7 Jahre. Beim Vergleich von Normal-personen und splenektomierten Patienten wiesen letztere eine deutlich erhöhte Rate an spontan-Immunglobulin-sezernierenden Zellen sowie eine stark verminderte Immunantwort nach Stimulation mit dem polyklonalen B-Zellaktivator Pokeweed Mitogen auf. Es bestand eine Tendenz zur Normalisierung dieser Störungen — insbesondere der hohen Rate an spontan-mmunglobulin-sezernierenden Zellen — während eines Zeitraums bis zu 7 Jahren nach Milzexstirpation. Um den Mechanismus, der für diese Störungen der Immunantwort bei Patienten nach Milzexstirpation verantwortlich ist, näher zu charakterisieren, wurden Experimente mit Lymphocytensubpopulationen durchgeführt. Diese erbrachten sowohl den Befund einer gestörten T-Helfer-zellfunktion als auch eines Defektes der B-Zellen selbst. Markeranalysen mit monoklonalen Antikörpern zeigten mit Ausnahme von OKT 4 und B 1, die T-Helfer/Inducer bzw. periphere B-Zellen markieren, normale Verhältnisse. Aufgrund der vorliegenden Untersuchungen scheint der Immundefekt bei splenektomierten Patienten hauptsächlich auf einer Dysfunktion der OKT 4 positiven Subpopulation (Inducer/Helper) zu beruhen.
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Abbreviations
- ISC:
-
Immunglobulin-sezernierende Zellen
- PWM:
-
Pokeweed Mitogen
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Sieber, G., Breyer, H.G., Herrmann, F. et al. Störungen der B-Zellaktivierung bei splenektomierten Patienten. Langenbecks Arch Chiv 363, 93–101 (1984). https://doi.org/10.1007/BF01261058
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DOI: https://doi.org/10.1007/BF01261058