title: Lymphokine-activated killer cells in primary immunodeficiencies and acquired immunodeficiency syndrome.
abstract: Cytotoxic mechanisms (e.g., natural killer (NK) lysis, antibody-dependent cellular cytotoxicity, and cytotoxic T lymphocyte lysis) play an important role in host defense against various infections and neoplasms. Lymphokine-activated killer (LAK) cytotoxicity, induced in vitro by incubating mononuclear cells with interleukin 2 (IL-2) for 2-5 days, may also represent an important component of the body's cytotoxic repertoire. In 10 patients with congenital cellular immunodeficiencies, including 5 with severe combined immunodeficiency, the mean LAK activity in a 3-hr chromium release assay against Raji target cells was 44 +/- 8.1%, which is equivalent to that observed in normal adults and neonates. In only one case, a patient with reticular dysgenesis, was there absent LAK cell generation. Haploidentical T cell-depleted bone marrow transplantation (BMT) restored LAK activity in this patient. LAK activity was first observed in this patient and two others 3-6 weeks following BMT, prior to other evidence of immunologic engraftment such as lymphocyte proliferation to mitogens, NK activity, or interferon-gamma production. One patient with adenosine deaminase deficiency showed normal levels of LAK activity despite absent NK activity. Three patients with chronic granulomatous disease also had normal LAK activity (57 +/- 14% specific lysis). In 9 patients with acquired immunodeficiency syndrome (AIDS), IL-2 activation resulted in a mean cytotoxic activity of 56 +/- 8.7% toward Raji targets. In addition, 9 patients with pre-AIDS complex also showed normal levels of cytotoxicity (37 +/- 3.3% toward Raji targets), equivalent to that of 8 normal controls, including two healthy homosexual males (mean lysis 38 +/- 3.9%). These results indicate that LAK cells appear early in immunologic ontogeny. Further, the mechanism of lysis is not oxygen dependent since LAK activity was present in the 3 patients with chronic granulomatous disease. The ability to generate LAK in a wide spectrum of immunodeficiencies may indicate that IL-2 could be used in therapy of such disorders.
authors.affiliation: Department of Pediatrics, UCLA School of Medicine 90024.
authors.forename: T W
authors.initials: TW
authors.lastname: Chin
authors.forename: S
authors.initials: S
authors.lastname: Plaeger-Marshall
authors.forename: A
authors.initials: A
authors.lastname: Haas
authors.forename: B J
authors.initials: BJ
authors.lastname: Ank
authors.forename: E R
authors.initials: ER
authors.lastname: Stiehm
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D016026:Bone Marrow Transplantation / Q000276:immunology; D003602:Cytotoxicity, Immunologic; D006105:Granulomatous Disease, Chronic / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007153:Immunologic Deficiency Syndromes / Q000276:immunology*; D007371:Interferon-gamma / Q000096:biosynthesis; D015979:Killer Cells, Lymphokine-Activated / Q000276:immunology*
chemical_list: D007371:Interferon-gamma