Selective blockade of the antigen-receptor-mediated pathway of T cell activation in patients with impaired primary immune responses.
We investigated impaired cellular immune responses of individuals on chronic hemodialysis by using monoclonal antibodies that trigger differential pathways of T cell activation. Reduced cellular reactivity, which exists in a high proportion of such patients, can be attributed to a failure of the monocyte population to support the process of primary T cell activation in vitro. This defect results in a lack of interleukin 2 production, which is critically dependent on a monocyte-derived signal. In contrast, T lymphocyte function was found to be physiologic. Perhaps more important, the degree of monocyte dysfunction in vitro correlated with the same patients' in vivo responses to hepatitis B vaccination. Addition of recombinant human interleukin 2 fully reconstituted their deficient immune response in vitro.
D000328:Adult; D000368:Aged; D000917:Antibody Formation; D000941:Antigens / Q000276:immunology*; D002455:Cell Division; D005260:Female; D006509:Hepatitis B / Q000276:immunology; D006801:Humans; D007154:Immune System Diseases / Q000188:drug therapy / Q000276:immunology*; D007376:Interleukin-2 / Q000096:biosynthesis / Q000276:immunology / Q000627:therapeutic use; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011971:Receptors, Immunologic / Q000502:physiology*; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology / Q000502:physiology; D014511:Uremia / Q000276:immunology / Q000628:therapy; D014611:Vaccination
D000941:Antigens; D007376:Interleukin-2; D011971:Receptors, Immunologic; D011994:Recombinant Proteins