Cytotoxicity against both Natural Killer (NK)-sensitive and NK-resistant targets can be induced by mixed lymphocyte culture reaction (MLR) and is referred to NK-like activity. Short-term cultures of mononuclear cells with recombinant interleukin-2 (IL-2) result in the appearance of considerable cytotoxicity against various targets (IL-2-activated killer, Lymphokine-activated killer (LAK)). This work intends to investigate the spectrum and specificity of these two cytotoxicities. When stimulated in vitro for 6 days with autologous Epstein-Barr virus-transformed lymphoblastoid cell line (LCL), the lymphocytes from Epstein-Barr virus seropositive human donors became cytotoxic for K 562, Molt-3 (NK-sensitive targets), Raji (NK-resistant target) and allogeneic LCL as well as autologous LCL. In contrast, IL-2-activated killer cells were cytotoxic also for K 562, Molt-3, Raji and allogeneic LCL, but not very much for autologous LCL. The cold-target inhibition test was used to analyze the specificity of these two cytotoxicities and revealed the similarity of them for all target cells tested. The cytotoxicity against NK-sensitive targets (K 562, Molt-3) was inhibited only by K 562 and Molt-3, which indicated that K 562 and Molt-3 have both NK and LAK target structures, but other cells only LAK target structure or alternatively that the wide spectrum effector cells have multiple receptors. The cytotoxicity against Raji was strongly inhibited by not only Raji but also K 562 and Molt-3, but not by LCL. Therefore Raji seemed to have LAK target structure of wider spectrum than that of LCL or to be killed by the effectors which have multiple receptors. The cytotoxicities against allogeneic LCL or autologous LCL were also inhibited by K 562, Molt-3 and Raji as well as target itself. The activated “NK cells” and the killer cells; LAK or LAK-like cells, with broad target spectrum including NK-resistant cells, are probably involved in these cytotoxicities. The cytotoxicity against autologous LCL was induced by MLR with autologous LCL, but not very much by IL-2. This suggested the presence of LAK-like cells not induced by IL-2. The biological role of these cytotoxicities is not yet well known. However, the cytotoxicity against autologous LCL by LAK or LAK-like killer cells with broad spectrum may be functioning in immune surveillance for Epstein-Barr virus-transformed cells.

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Peripheral blood T-lymphcyte subsets defined by monoclonal antibodies (OKT-series; OKT3: pan T-cell, OKT4: inducer/helper T-cell, OKT8: suppressor/cytotoxic T-cell) were analysed in patients with gastric cancer.
The results were as follows.
(1) Percentages of OKT3⁺, OKT4⁺ and OKT8⁺ cells as well as the OKT4/OKT8 ratio showed no significant change according to the clinical stages.
(2) In recurrent cases, proportion of OKT4⁺ cells was decreased and that of OKT8⁺ cells was increased, and the OKT4/OKT8 ratio was reduced, compared with cancer free patients after operation.
(3) The OKT4/OKT8 ratio was not correlated with the percentages of IgGFcR⁺ T-cell (Tγ) and ConA/PHA ratio.
(4) In patients with high proportion of Tγ and low OKT4/OKT8 ratio, the peripheral blood T-cell response to PHA was deminished.
(5) The OKT4/OKT8 ratio was remarkably decreased after palliative operation.

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Diffuse panbronchiolitis (DPB) is a disease with chronic inflammation localized mainly in the region of the respiratory bronchioles. Chronic respiratory infection including Pseudomonas aeruginosa infection is the common complication of DPB in the advanced stage. For the purpose of studying defense mechanisms in DPB patients, peripheral blood B lymphocyte function in 23 DPB patients and in normal controls was evaluated.
First, the capacity to generate immunoglobulin secreting cells (Ig SC) in vitro in response to pokeweed mitogen (PWM) and the number of spontaneous Ig SC were evaluated. Peripheral blood mononuclear cells (PBMC) in DPB patients were markedly deficient in their capacity to response to PWM with differentiation of Ig SC. This diminished responsiveness could not be ascribed to the deficiency of helper T cell activity, the presence of increased numbers of cells with suppressive capacity or adherent suppressor cells. DPB patients had significantly higher spontaneous Ig SC than normal controls.
Interleukin-1 (IL-1) is a monocyte product with diverse amplifying effects on immune cell responses. The production of IL-1 by monocyte from DPB patients under stimulation of lipopolysaccharide (LPS) was examined. Monocytes from DPB patients produced IL-1 activity not less than those of normal controls.
Secondly, the response of B lymphocytes to B cell growth factor (BCGF) and B cell differentiation factor (BCDF) was examined. T cell culture supernatant in healthy volunteers was used as T cell factor containing BCGF and/or BCDF activities. Although B lymphocytes from DPB patients proliferated in response to BCGF in the presence of anti-Ig M stimulation, did not produce Ig G in response to helper T cell factor containing BCGF and BCDF activities.
These data indicate us the presence of polyclonal activation of B lymphocytes in vivo in DPB patients. The mechanisms for B cell activation in patients with DPB might be heterogeneous. These findings may contribute the understanding of the immunoregulatory impairment in DPB.

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Immunological findings were evaluated in 2 males and 3 females between the ages of 48 and 59 years in whom a definitive diagnosis of immunoblastic lymphadenopathy (IBL) was made from the histological findings obtained in lymph node biopsies and at autopsy (4 patients).
Many of these patients exhibited drug hypersensitivity which could also have prompted the onset of disease. Pruritus, eruptions, and recurrent fever were also experienced. In addition to enlargement of superficial lymph nodes all over the body, mediastinal lymph nodes were also enlarged and hepatosplenomegaly was observed in 4 patients. Complications from infection and autoimmune hemolytic anemia were also found, and infection was in fact responsible for the death of 3 of 4 patients. Various abnormal antibodies also appeared, and the antiglobulin test was positive in 3 of 4 patients tested, showing polyclonal hypergammaglobulinemia. In 1 patient, Fc fragment was found in the urine. Abnormal cell-mediated immunity was also found. The response of peripheral lymphocytes to Con A was decreased. Ig secreting cells markedly increased in response to PWM, suggesting an activation of the antibody-producing system. The serum of the patient showed an inhibition of blast formation in response to the PHA and MLC test. Helper T cell hyperfunction and suppressor T cell hypofunction is apparently present in patients with IBL, suggesting a serum factor that suppresses T cell function.

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We studied the distribution of autologous rosette-forming cells (ARFC), the population of T cell subsets, autologous mixed lymphocyte reaction (AMLR) and allogeneic mixed lymphocyte reaction (allo-MLR) in the peripheral blood of 20 healthy adult donors and 16 patients with IgA nephropathy. The mean percentages of ARFC were markedly reduced (p<0.001) in the patients compared with the healthy controls. OKT3 (pan-T) cells and OKT4 (helper/inducer T) cells were significantly reduced (p<0.001) when compared to healthy controls. AMLR is impaired or absent in most patients with IgA nephropathy. The response of T cells to allogeneic normal non-T cells was diminished in patients when compared to normal cases.

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The occurrence of autoimmune hemolytic anemia (AIHA) in patients with immunodeficiency diseases has been described. Either increased or decreased immunoglobulin levels have also been observed in sera of many patients with AIHA, although a severe depression of immunoglobulin levels is rare.
In this report, we described a patient with idiopathic AIHA caused by IgG antibody, who was associated with severe IgM deficiency (7mg/dl) at the time of acute hemolytic attack. Both serum IgA (408mg/dl) and IgE (1, 090u/ml) were increased, whereas IgG (759mg/dl) was slightly decreased. In peripheral blood, the percentage of B lymphocytes identified as surface immunoglobulin-bearing cells was normal; the percentage of total B lymphocytes was 7.3% and those of IgG-, IgA- and IgM-bearing cells were 7.7%, 2.0% and 3.7%, respectively. However the number of T lymphocytes including OKT3⁺, OKT4⁺ and OKT8⁺ cells were markedly decreased.
After the treatment with methyl prednisolone, normalization of serum IgM level was observed with clinical improvement of hemolysis.

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A seventy-two-year old female had chest pain since October 1981. In July 1982, she was admitted for congestive heart failure. In October 1982, compression fractures of vertebrae on Th12 and L1, and Bence Jones protein in the urine were found. She was transferred to our hospital for further examination about multiple myeloma in November 1982. Her laboratory data included mild normocytic normochromic anemia, leukocytes 9, 600/cmm, plasma cells 34% in peripheral blood, total protein 4.5g/dl, decreased all classes of immunoglobulins, BUN 99mg/dl, and creatinine 6.9mg/dl. Her serum and urine showed M-bow only against anti-λ antiserum in immunoelectrophoresis. She was diagnosed as Bence Jones λ type plasma cell leukemia associated with renal failure.
Her renal function was gradually improved after chemotherapy and plasmapheresis were started. After a month her renal function became worse, but the response to further treatments including chemotherapy and plasmapheresis could not be obtained. She was died of renal failure on 19th December 1982.
In autopsy specimen, many tubular casts and Bence Jones λ type proteins in tubular epithelial cells were found.
Bence Jones proteins were purified from patient's urine by ammonium sulfate precipitation method followed by DEAE column chromatography. This purified λ type Bence Jones proteins were used as a standard marker in the measurement of λ type free light chains in the patient's serum. Patient's serum free light chains were serially measured during her clinical course, and were markedly decreased after initial treatment.
We discussed about the negative role of Bence Jones proteins on renal function in multiple myeloma.
Plasmapheresis treatment along with chemotherapy shows beneficial effect on renal function mainly by removing free light chains from the serum in the patient with Bence Jones type multiple myeloma.

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A case of D-Penicillamine induced polymyositis in progressive systemic sclerosis.
Nowadays D-Penicillamine (D-PC) is widely used for treatment of rheumatoid arthritis. It is also employed to treat patients with progressive systemic sclerosis (PSS) from viewpoints of favorable pharmacological effects on such as inhibition of collagen synthesis and modulation of deranged immune functions.
Although various side-effects have been reported up-to-date, much attention has not paid on occurrence of polymyositis in D-PC treatment.
We experienced a case of PSS who had manifested a typical polymyositis during D-PC treatment and bad recovered completely from it on discontinuance of the drug.
A 51-year-old woman was admitted to another hospital because of Raynaud's phenomenon and sclerodactylia. She was treated with glucocorticoids for several months. With a slight improvement of the symptoms she discharged from it and stayed at home. She, thereafter, became gradually aggravated and started to complain of severe dyspnea. She was admitted to our University Hospital. As chest X-ray showed a marked pulmonary fibrosis, D-PC was given in a dose of 100mg daily for 4 weeks and then in a dose of 200mg daily. During the treatment, she complained of myalgia and muscle weakness accompanied with elevated values of serum creatinine phosphokinase (CPK) and aldolase (ALD). Electromyogram and muscle biopsy showed findings compatible with polymyositis. One month after discontinuation of D-PC, physical and laboratory abnormalities of polymyositis were completely normalized.
We concluded that polymyositis seen in this patient could have been induced with D-PC, aparting from a notion that D-PC had manifested latent polymyositis included in a morbid spectrum of PSS.

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A 36-year old female was admitted to our hospital because of fever and discoid lupus. The patient's illness began at the age of 33 when she had facial erythema and hair loss.
On admission, laboratory examination revealed proteinuria, elevated ESR, lymphopenia, a high titer of anti-DNA antibody and hypocomplementemia. She responded well to steroid therapy. Three months after admission, tooth extraction was performed, when immunosuppressant therapy was combined. One month after, she had fever, proteinuria and cardiac diastolic murmur. Laboratory data revealed elevated ESR and positive CRP. UCG and PCG showed findings of aortic regurgitaion. Enterococcus was repeatedly found in blood culture. She was diagnosed as being complicated with bacterial endocarditis. One month of high doses of antibiotics therapy resulted in negative blood culture, and other symptoms disappeared. Eleven months after admission, she had fever, proteinuria and hypocomplementemia, and enterococcus was detected in blood culture again. The titers of antienterococcus antibody were 1:50 at first time and 1:800 at second time.
The pathogenesis of aortic regurgitation due to bacterial endocarditis in inactive stages of the disease was thought o be closely associated with tooth extraction and immunosuppressant therapy.
Some discussions have been made concerning the pathogenesis of endocarditis in patients with SLE judging from clinical course and immunological studies of this patient.

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The primary role of the thymus in immunological function is unanimously recognized. It is also proposed that hypothalamus, hypophysis and adrenal system may be acting as a factor to control immunological activity, but the detail mechanism of this system remains inclarified.
We have reported that serum immunogloblin levels in hypophysectomized rats and adrenalectomized rats have elevated.
We analysed surface cell markers (W 3/13, W 3/25 and ox 8) of lymphoid tissue cells (thymus, spleen and peripheral blood lymphocytes) in rats either hypophysectomized or adrenalectomized using by FACS 440. Ox 8⁺ peripheral blood lymphocytes decreased and W 3/25⁺/ox 8⁺ ratio of spleen lymphocytes and peripheral blood lymphocytes elevated in hypophysectomized and adrenalectomized rats.
These results suggest that hypophysis and adrenal axis have the potential to regulate immunological system.

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