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Antibody fragments can be expressed at a high level in microbial systems, but they may have limited therapeutic value because they are rapidly eliminated from the body. We demonstrate here that site-specific conjugation or binding of bacterially derived Fab' to the long-lived protein serum albumin allows full retention of the antibody's binding characteristics while imparting the albumin's longevity in vivo. In rats the area under the curve for Fab' conjugated to rat serum albumin was 17-fold greater than for the control of Fab' conjugated to cysteine. Again, a bispecific F(ab')(2) with specificity for rat serum albumin showed an area under the curve about 8-fold greater than did a F(ab')(2) without specificity to albumin. Genetic fusions of scFv to albumin were similarly long-lived and could be expressed in yeast to provide the basis of a cost-effective production system.

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Fab's with hinges based on the human gamma1 sequence containing 1, 2, or 4 cysteines have been produced by high level Escherichia coli periplasmic secretion, and coupled in vitro by reduction/oxidation to form F(ab')2. We find that the F(ab')2 made with hinges containing 2 or 4 cysteines have a high level (approximately 70%) of multiple disulphide bonds. These F(ab')2 molecules have an increased pharmacokinetic stability as measured by area under the curve compared to those made by direct coupling through a single disulphide bond. One particular molecule containing 4 hinge cysteines has a greater pharmacokinetic stability than a F(ab')2 formed by chemical cross-linking. F(ab')2 made from the Fab' with 4 hinge cysteines is also relatively resistant to chemical reduction in vitro allowing partial reduction to expose reactive hinge thiols. These hinge sequences provide a simple method for producing robust F(ab')2 in vitro, obviating the need to use chemical cross-linkers, and provide a route to hinge specific chemical modification with thiol-reactive conjugates.

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Steroid hormones, such as glucocorticoids (GC), influence immune and inflammatory responses through their suppressive actions. Recent evidence suggests that another steroid hormone, dehydroepiandrosterone (DHEA), provides an immunostimulatory influence opposing the effect of GC. DHEA circulates in its inactive sulphated form, DHEAS, requiring conversion to DHEA by a steroid sulphatase (SS) enzyme for biological activity. Therefore, inhibition of SS activity may affect immune responses, allowing endogenous GC effects to predominate. We have shown that administration of DHEA and DHEAS in contact sensitization (CS) augments ear swelling by 39 and 46% respectively (P < 0.001). DHEAS at doses of 0.5, 5 and 50 mg/kg reverses the inhibitory effect of corticosterone (5 mg/kg) (P < 0.01). In CS, CT2251 (SS inhibitor) at 10 and 0.1 mg/kg inhibited ear swelling by 61 and 38% (P < 0.05) respectively. In addition, it inhibited DHEAS-augmented responses by 49 and 35% respectively (P < 0.05), with no effect on DHEA-augmented responses. DHEAS reversed CT2251 inhibition of the CS response with complete reversal at 50 mg/kg (P < 0.05). DHEAS and CT2251 appear to affect cellular infiltration into the ear, since DHEAS increased the number of lymphocytes by 63.8% and macrophages by 107% (P < 0.001), whereas CT2251 at 0.1 mg/kg decreased the number of lymphocytes by 65% (P < 0.001) and macrophages by 80% (P < 0.001). DHEAS, CT2251 and dexamethasone had no effect on oedema in the ear. From our data we have shown that steroid hormones, such as DHEA, have the potential to act as immunostimulatory factors in vivo. Inhibiting the conversion of DHEAS to DHEA by SS enzyme leads to an anti-inflammatory effect.

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Despite the increasing numbers of paediatric transplants performed, little is known about the immune responses of T lymphocytes in human neonates. Here we have compared the effects of cyclosporine on the phytohaemagglutinin (PHA) response of immature (cord) and mature (adult) lymphocytes using the following parameters of activation: (i) proliferation, measured by 3H-thymidine uptake; (ii) expression of cell surface IL-2 receptor; (iii) release of IL-2 into the supernatant. Cyclosporine was added to cultures of PHA-stimulated lymphocytes at doses ranging from 5 to 5000 ng/ml. The proliferative response of cord lymphocytes was considerably more sensitive to cyclosporine at each dose, so that 50% inhibition was achieved by 6 ng/ml and 21.5 ng/ml doses of cyclosporine on cord and adult lymphocytes, respectively. Expression of the IL-2 receptor by PHA-activated T cells and their subsets was assessed by flow cytometry. Cyclosporine inhibited IL-2 receptor expression to a significantly greater degree in cord CD4 and CD8 cells (49.7% and 70.1%) than in adults (17.9% and 30.0%). Biologically active IL-2 release was measured using the IL-2-dependent cell line CTLL-2. Cyclosporine at doses 50-5000 ng/ml produced 80-99% inhibition of both cord and adult responses. However, at very low doses (5 ng/ml) cyclosporine produced 69.3% inhibition of cord lymphocytes, compared with 42.0% of adult lymphocytes. These results suggest that the T cells of neonates are considerably more sensitive to cyclosporine than are adult T cells.

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Immune complexes containing human gamma (g)1 or murine g2a antibodies generate secondary effector mechanisms via Fc receptor binding or complement activation, whereas those containing human g4 or murine g1 antibodies generally do not. Therefore, isotype selection of therapeutic antibodies may have important clinical consequences. In a rabbit model of human tumor necrosis factor (rhuTNF)-induced pyrexia, a murine/human chimeric g4 anti-human TNF-alpha monoclonal antibody (mAb) (cCB0011) showed a dose-dependent inhibition of pyrexia, whereas a g1 isotype variant of the same mAb gave a marked pyrexia that was seen at all doses indicative of an immune complex-mediated response. To investigate whether isotype difference could influence mAb efficacy in pathological disease states, hamster/murine chimeric g1 and g2a anti-murine TNF-alpha mAbs (TN3g1, TN3g2a) were studied in experimental shock in mice and rats. In lipopolysaccharide-induced shock in mice, treatment with TN3g1 mAb at 30 and 3 mg/kg resulted in 90% survival by 72 h (p < or = 0.004), and prolonged survival to 45 h (p < or = 0.05), respectively, compared with 100% mortality by 27 h in controls. In contrast, a g2a isotype variant of the same mAb (30 mg/kg) resulted in only 10% survival by 72 h (p < or = 0.05). In a neutropenic sepsis model in rats there was greater survival in animals receiving the g1 isotype of TN3 compared with g2a isotype variant (70 vs. 27%; p < or = 0.005) with 100% mortality in the controls. These differences were not due to the pharmacokinetic profiles of the mAbs. In models of experimental shock antibody isotype can affect outcome with inactive isotypes (human g4 and murine g1) being more efficacious than active isotypes (human g1 and murine g2a).

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The contribution of 5'-nucleotidase and AMP-deaminase to adenine nucleotide degradation in human cardiomyocytes isolated from diseased or normal heart was investigated. The preparation used contained 30 to 50% of viable cells and the nucleotide degradation was stimulated by addition of deoxyglucose and oligomycin. To distinguish pathways of nucleotide degradation, adenosine deaminase was inhibited by erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA). Under these conditions, ATP concentration was decreased by 60% after 45 min of incubation. Simultaneously, increases in intra- and extracellular catabolite concentrations have been observed. Adenosine was the predominant catabolite found in both the cells and in the extracellular medium accounting for more than 70% of all degradation products. Intracellular adenosine concentration rose to 300 times greater than that outside the cell. An increase in intra- and extracellular inosine was also seen. Only a small increase of IMP concentration was observed. No hypoxanthine accumulation was found. No significant change in initial adenine nucleotide concentrations were observed in isolated cells during aerobic incubation without deoxyglucose and oligomycin. In conclusion, a pathway involving adenosine production appears to be the principal route of nucleotide degradation in human cardiomyocytes.

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Lymphocytes were cultured from cardiac biopsies following heart transplantation using interleukin-2-conditioned medium. Using the technique of limiting dilution analysis the frequency of donor specific cytotoxic T lymphocytes was measured in cells cultured from biopsies and compared with that in peripheral blood lymphocytes taken at the same time as the biopsy. The graft cell population showed a considerably higher frequency of donor-specific CTL when compared with the PBL. CTL frequencies in the graft cells were always higher against the donor than against third-party cells. These data demonstrate that there was either selective sequestration or selective expansion of donor-reactive T cells in the heart following cardiac transplantation. These results emphasize the need to investigate more closely the events occurring in the heart, and may explain the lack of specificity and sensitivity in immune monitoring (IM) or cytoimmune monitoring (CIM) seen in many centers.

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Class I induction on the myocardium of transplanted heart was investigated with regard to its temporal relationship to rejection episodes, how it is affected by anti-rejection therapy and whether it is dependent upon the presence of a T cell infiltrate in the biopsy. Sequential cardiac biopsies (total 114) from 11 patients from the time of transplant to 1 year after transplant were studied using immunocytochemical techniques. The effect of different immunosuppressive regimens on MHC antigen expression was also studied. All the biopsies diagnosed as showing rejection for the first time showed induction of Class 1 on the myocardium with 79% during subsequent rejection episodes. Class I induction was associated with a leucocyte infiltrate, not always containing T cells, and disappeared in 47% of biopsies taken 3-4 weeks after treatment with steroids and/or ATG. Increased expression of Class II, in particular DQ antigens on interstitial structures, paralleled Class 1 induction. MHC antigen expression returned to normal in 8/9 patients, at 1 year after transplant. Different immunosuppressive regimens affected the number of biopsies showing Class 1 induction on the myocardium. Our results suggest that in clinical heart transplantation class I induction is related to the rejection process.

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The effects of graft-versus-host-disease (GVHD) on different tissues and cells were studied. High and low lymphocyte doses were employed for the induction of GVHD, and the results were compared. It was shown that ear skin was more susceptible to attack than abdominal skin. It is speculated that this could be due to the different vascular networks in the two areas. Weight loss, skin erythema, splenomegaly, histology, and Langerhans' cell density were used to assess GVHD. The Langerhans' cell density was assessed using the Ia antigen cell marker. It is shown that Langerhans' cell density is a sensitive index for confirming GVHD. Weight loss is the least sensitive indicator. The features of GVHD occurred earlier and were more severe in animals receiving the higher dose of lymphocytes, with Ia antigen appearing on the keratinocytes in the later stages of the disease. We conclude that Langerhans' cells are sensitive to the effects of GVHD and that they can provide a diagnostically useful indicator of the disease.

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Immunohistochemical analysis was performed on skin biopsies from patients suffering from graft versus host disease (GVHD) following bone marrow transplantation for aplastic anaemia and leukaemia. Lymphoid cells infiltrating the skin were exclusively T cells with the OKT8+ phenotype and these are probably cytotoxic T cells. Langerhans cells were reduced in number in all specimens and a variable number of HLA-DR positive macrophages were seen in the dermis. In several cases HLA-DR antigens were expressed on keratinocytes. These results show consistent features which may help discriminate rashes in the skin in the post-transplant period.

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Ia antigen is seen in the normal epidermis only in Langerhans cells. However, when there is damage to the epidermis induced by cellular immunity Ia is expressed in the keratinocytes. This phenomenon is not seen in trauma or chemical inflammation. It is suggested that the expression of Ia in keratinocytes is due to cellular immunity possibly due to a lymphokine.

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