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Cellular Recognition and Activation within the Lymphoid System J O H N H. K E R S E Y , M.D., A N D G L E N J. B O O T H Departments of Laboratory Medicine and Pathology and Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455 ABSTRACT Kersey, John H., and Booth, Glen J.: Cellular recognition and activation within the lymphoid system. Am J Clin Pathol 63: 6 2 9 - 6 3 5 , 1975. The present study is concerned with cellular recognition and activation within the lymphoid system. Data presented indicate that in human peripheral blood phagocytes recognize and preferentially bind phagocytes, and thymus-derived (T) lymphocytes recognize and preferentially bind other T lymphocytes rather than thymus-independent (B) lymphocytes. Recognition of non-self results in activation of lymphoid cells; recent data using a calcium ionophore, A23187, suggest that calcium may act as an intracellular messenger by which signals for cellular activation are transmitted from the cell surface to the nucleus. (Key words: Lymphocytes; Cellular recognition.) cellular activation, and the immune response are not new to scientific investigators. For example, Paul Ehrlich, in 1900, described cell membrane receptors in a manner that in many ways seems satisfactory to us today. 12 He stated that cell receptors were the "catching arms" of cells that would bind specific substances. If the substance is toxic, the cell will be killed. "If the cell is not killed the receptors would be generated in excess, some would float off into the serum and there function as a specific antibody for the foreign substance." Similarly, hypotheses popular today suggest that cellular receptors specifically bind STUDIES O F CELLULAR RECEPTORS, Received October 29, 1974; accepted for publication December 9, 1974. Supported in part by Virus Cancer Program contract number N01-CP-33357 and Grants no. CA-7306 and CA-16228 from the U.S. Public Health Service. Reprints of this entire Research Symposium are available from the ASCP Meeting Services Department, 2100 West Harrison St., Chicago, Illinois 60612, for $3.00 per copy. 629 substances that may be toxic (e.g., other antibodies), friendly (e.g., other similar cell types) or hostile (e.g., histoincompatible cells or tumor cells). From another perspective, when one looks at the phylogenetic tree one also gets the impression that there's not much new in cellular recognition and cellular receptors. Today, I would like to review briefly some aspects of the phylogenetic development of cellular recognition and cellular communication. I would then like to present some data which suggest that, contrary to some fondly held beliefs, cellular recognition processes may play only a limited role in the development of malignancy. It is of some interest that animals that are rather early in phylogenetic development often have the capacity to distinguish differing members of the species from themselves. In one of the earliest multicellular organisms, the sponge, Humphreys showed clearly that red sponge 630 KERSEY AND BOOTH A,J.C.P.— Vol. 63 cells recognize and bind red sponge cells, containing iron or latex were considered to and lavender sponge cells recognize and be phagocytes; the remaining mononuclear bind lavender sponge cells.6 It is interesting cells were identified as lymphocytes. that tumors are almost unheard of in E-Rosette Assay these early ancestors who have no specialized immune system. With the developFor experiments characterizing lymment of tissue and organ systems in more phoid subpopulations, lymphocytes were specialized animals, we see evidence of purified by incubating the leukocyte-rich more specific cellular interactions. Classic plasma with an equal volume of carbonyl experiments by Moscona and his students, iron-latex suspension for 60 minutes at for example, indicate that kidney cells 37 C. on a rocker platform. This mixture will preferentially bind kidney cells and was layered on a Ficoll-Hypaque gradient liver cells will bind liver cells when the and centrifuged at 400 X g for 45 minutes. two are mixed together. This type of organ- The cells at the interface were collected, specific recognition can be best demon- washed three times with D-PBS, and ad6 strated in embryonic cells.13 We recently justed to a concentration of 4 X 10 per cu demonstrated what may be similar type- cm in D-PBS plus 10% heat-inactivated specific interactions in mononuclear cells fetal calf serum. Suspended cells were centrifuged at 200 X g for 3 minutes to inof human peripheral blood. crease cell-to-cell contact. The lymphocytes were gently resuspended and mixed Materials and Methods with an equal volume of washed sheep H u m a n venous blood collected in erythrocytes, centrifuged at 200 X g for 3 heparin and sedimented in 5% dextran minutes, and incubated at 4 C. for one was prepared according to the two follow- hour. The pellet was gently resuspended ing protocols. and counted on a standard hemocytometer. Phagocytosis Experiment Fifty pairs of cells in which both of the T h e leukocyte-rich plasma obtained from dextran sedimentation was treated with tris-ammonium buffer for 10 minutes at 37 C. T h e cells were washed and incubated with an equal volume of carbonyl iron-latex suspension for 60 minutes at 37 C. on a rocker platform. They were washed three times with Dulbecco's phosphate-buffered saline solution (D-PBS). After the final wash, the cells were resuspended at a concentration of 4 X 106 per cu cm in D-PBS plus 10% heat-inactivated fetal calf serum and incubated at 4 C. for one hour. Finally, the cells were gently resuspended and counted in a standard hemocytometer. In each preparation, 50 clearly recognizable pairs of cells in contact were counted under a light microscope. Cells cells in contact could be clearly identified were counted under a light microscope. Cells that phagocytized latex were not counted. Latex-negative lymphocytes binding two or more erythrocytes were considered to be T cells; latex-negative lymphocytes not binding erythrocytes were considered to be either B cells or "null" cells. Results Approximately 2 to 5% of cells prepared according to the above protocols were observed to form pairs or larger multiples. Cell contact generally remained stable throughout the period of observation. In many instances a slight indentation of the surface of one or both of the paired cells was noted in the area of contact. Experi- May 1975 LYMPHOCYTES AND CELLULAR RECOGNITION 631 40- | FlG. 1. Percentage observed versus predieted pairings of lymphocytes (L) and phagocytes (P) in human peripheral blood. »• 30 ' 20- 10- L-P 0 • Observed Predicted ments performed at 4, 20, and 37 C. established that the extent of pairing was the same at these temperatures. Further experiments were conducted to determine whether these pairings were based on random interactions between cells or whether contacts were established between specific cell types. The shaded bar graphs in Figure 1 represent the percentages of lymphocyte plus lymphocyte (L + L), lymphocyte plus phagocyte (L + P), and phagocyte plus phagocyte (P + P) contacts observed in phagocytosis experiments. Interpopulation (P + P, L + L) contacts accounted for 83% (P + P = 45%, L + L = 38%) of all observed pairings. The unshaded bar graphs represent the predicted percentages of the various pairs, assuming random association using the formula fL2 + 2fL • fp + fP2 = 1. T h e most significant variation between observed and predicted percentages was found in interpopulation (L + P) contacts. Calculations based on the assumption of random association between all cells in contact predicted that 48% of the pairs would be L + P. In our experiments, only 17% of the observed pairs were L + P. Subsequent investigations of the nature of the interaction between subpopulations of the lymphoid population were accomplished by performing E-rosette assays on L + L contacts. T h e shaded bar graphs in Figure 2 represent the percentages of T-lymphocyte plus T-lymphocyte (T + T), T-lymphocyte plus B-lymphocyte (T + B), and B-lymphocyte plus B-lymphocyte (B + B) contacts observed in the E-rosette assay experiments. Contacts between members of the same lymphoid subpopulation (T + T, B + B) accounted for 77% (T + T = 18%, B + B = 59%) of all observed pairings. T h e unshaded bar graphs represent the predicted percentages of the various pairs, assuming random association of the lymphocytes in contact. The most significant variation between observed and predicted percentages was found in contacts between members of different lymphoid subpopulations. Assuming random pairing, intersubpopu- 632 KERSEY AND B O O T H A.J.C.P. —Vol. 63 FIG. 2. Percentage observed versus predicted pairings of sheep erythrocyte-binding (T) and non-erythrocyte-binding (B) lymphocytes in human peripheral blood. T.T E2 ObsarvM • Predicted lation pairing (T + B) was predicted to occur in 40% of all pairs. T + B pairing was observed in 23% of all pairs. Discussion Like-like relationships may be demonstrated in the sponge, in the liver and the kidney, and now with human phagocytes, T lymphocytes, and B lymphocytes. T h e relationships demonstrated may be important for cellular communication and the development of specialized organ systems throughout phylogeny. Recognition of non-self clearly results in destruction of the non-self component in many instances; it is of interest that this destruction is demonstrable in phylogeny before evidence of a specialized lymphoid system. For example, in the marine colonial hydroids, Theodor demonstrated that mutual destruction results from the interaction of incompatible members of the same species. 5 In these early non-immunologic recognition systems the presence of one common component is sufficient to result in recognition of another as friend rather than foe. In other words, if two marine forms are in any way related, they will recognize each other as friends and not destroy each other. It seems likely that these early recognition systems, while maintaining integrity of self, would not be very effective in eliminating malignant cells. Such a statement seems relatively safe since it is likely that while malignant transformation may result in new surface antigens, many of the old familiar antigens of the nontransformed cells will remain. If such is the case, we have difficulty understanding how a normal coral cell could recognize and destroy a malignant coral cell or a normal kidney cell a malignant kidney cell. Perhaps it is the lymphoid system which is capable of recognizing and destroying malignant cells. Let us examine the evidence. The development of a system that specializes in cellular recognition {i.e., the lymphoid system) appears to have beginnings rather early in phylogeny. Our spiny-skinned ancestors, the echinoderms, e.g., the starfish, are found to have circulating lymphoid cells.19 The starfish and May 1975 LYMPHOCYTES AND CELLULAR RECOGNITION 633 another ancestor, the sea cucumber, have Table I. Possible Causes of Lymphoreticular Malignancies in Immunodeficient the ability to reject grafts of foreign skin Patients (albeit rather slowly, since the job often 19 takes several months). Increased malignant transformation of lymphoid cells Certain evidence suggests that the phylo- due to: genetic developments of specialized im(a) Intrinsic defects in lymphoid cells (e.g., chromune systems occurred at about the same mosomal breaks) (b) Increased activity of exogenous and endogenous time as animals began to bear living young. oncogenic viruses Speculation of Burnet and others runs that specialized immunocytes assisted in the Decreased ability of the lymphoid system to recognize defense against parasitism of parents by and destroy malignant lymphoid cells: their own offspring. 3 It is rather unlikely (a) Defective recognition that development of this specialized im(b) Defective response following recognition mune system was especially useful in host defenses against microorganisms, since the plants and early animals without im- Such anterior mediastinal lymphomas, we mune systems thrived side by side with and know today, almost invariably involve T often in symbiosis with their microorgan- cells, in that they have the capacity to isms. Similarly, from the phylogenetic per- form rosettes with sheep erythrocytes, a spective, it is difficult to imagine that the reliable marker of human T cells.7 Studies system provided any new defense against of children with the various immunodemalignant cells, since those ancestors with- ficiency syndromes continue through an out immune systems appear not to be Immunodeficiency-Cancer Registry esparticularly plagued by neoplasms. tablished at Minnesota. 9 We now know of Another approach to the question of the almost 200 persons with immunodeficiency possible role of the immune system in the who developed cancers; the risk of dedefense against malignant cells is to ex- velopment of these cancers is about 100 amine the effect of elimination of the times that of the general population. It immune system. Our studies involved is of interest that the types of malighuman individuals and date back to the nancies are quite different from those of early 1960's. At that time, reports by Page, an unselected population. About 8% of ten Bensel, Krivit, Good and others at tumors in unselected children are lymphoMinnesota indicated that children with reticular; in contrast, 67% of the maliggenetically determined immunologic de- nancies are lymphoreticular solid tumors ficiency syndromes that involved the im- (including l y m p h o m a , reticulum-cell mune system were at high risk for develop- sarcoma) or leukemia in children with ment of cancer. 4 These syndromes may, primary immunodeficiency disorders. 10 as you know, be classified into those inAnother group of immunodeficient volving the lymphocytes that are thymus- patients, those who are immunosuppressed derived (T) cells, and those that are with drugs for renal transplantation, also thymus-independent and involve (B) often develop lymphoreticular tumors. bursa-equivalent or bone marrow cells. These lymphoreticular tumors frequently An early example was a child with repeated involve the brain. 15 T h e reasons for the infections and the syndrome of X-linked frequent lymphoid malignancies in imagammaglobulinemia known to be asso- munodeficient individuals could be several, ciated with B-cell deficiency. This child and include those listed in Table 1. Our developed a large anterior mediastinal findings and those of others indicate that lymphoma, presumably in the thymus. 14 there is only a slight increase in non- 634 KERSEY AND BOOTH lymphoid malignancies in immunodeficient patients. 10,15 In the same vein, Stuman observed that nude mice (i.e., mice with a severe genetically determined immunodeficiency) were not at increased risk for spontaneously occurring or chemically-induced neoplasms. 18 These results are, of course, in contrast to some earlier reports indicating that laboratory infections of immunodeficient mice with some oncogenic viruses resulted in increased tumor incidence. 8 Because of these recent observations, we are somewhat skeptical of hypotheses suggesting that a major function of the lymphoid system is to provide surveillance against malignant cells that develop within the liver, kidney, brain, and other organs. In fact, it is remarkable that cancer is a relatively infrequent disease in both normal and immunodeficient individuals, despite daily exposure of billions of cells to dozens of environmental carcinogens. To turn to a different but related subject, we have recently been interested in the membrane consequences of the interaction of non-self components with specific cellular receptors. In particular, we were interested in signals that might be generated at the cell surface that could be translated to the cytoplasm and cell nucleus and result in cell activation and cell division. Some evidence suggests that calcium may act as such a signal. Data presented by Alford, 1 Allwood and colleagues, 2 and Whitney and Sutherland 20 indicated that calcium was required for activation of lymphocytes by nonspecific mitogens, e.g., phytohemagglutinin. Additionally, Whitney and Sutherland showed that activation resulted in significant influx of calcium from the external medium. 21 We approached the problem using an antibiotic derived from cultures of a type of Streptomyces known as A23187. This antibiotic is known as an ionophore because it selectively transports ions across cell membranes. This particular ionophore A.J.C.P.—Vol.63 selectively transports divalent cations with highest affinity for calcium. 16 It is of note that this ionophore affects the eggs of one of our echinoderm friends, the sea urchin. Steinhardt and Epel noted that the ionophore stimulated calcium-dependent protein and DNA synthesis in the eggs of this species.17 Our studies indicate that the ionophore will stimulate blast transformation and DNA synthesis in human lymphocytes.11 Activation of lymphocytes requires calcium and, to a lesser extent, magnesium, in the external medium. More than two hours of contact of ionophore with lymphocytes is necessary for optimal activity.11 In summary, the cell membrane appears to be the site of specific interaction of friend and foe in all species and in many cell types throughout phylogeny. These interactions, which require specific membrane receptors, appear to be important in tissue and organ formation and in interactions with microorganisms, even prior to development of specific i m m u n e responses. Lymphocytes and other cells that mediate these specific immune responses, which are found as early as the starfish and other echinoderms, are rather latecomers in the evolutionary scheme of things. We later vertebrates are clearly dependent in this respect, however, as death from infection quickly ensues when they are defective. The role of these specialized lymphoid cells in the defense against malignancy remains a matter of continuing controversy, and I suspect the data will show that they are less important than we had previously suspected. One consequence of cell-to-cell interaction may be cellular proliferation. Certain evidence suggests that calcium may be involved as an intracellular mediator to communicate a membrane signal to the cytoplasm and the nucleus. Ongoing studies of signal formation may assist in the understanding of both normal and malignant cells. May 1975 LYMPHOCYTES AND CELLULAR RECOGNITION References 1. Alford RH: Metal cation requirements for phytohemagglutinin-induced transformation of human peripheral blood lymphocytes. J Immunol 104:698-703, 1970 2. Allwood G, Asherson GI, Davey MJ, et al: The early uptake of radioactive calcium by human lymphocytes treated with phytohemagglutinin. Immunology 2 1 : 5 0 9 - 5 1 6 , 1971 3. Burnet FM: "Self-recognition" in colonial marine forms and flowering plants in relation to the evolution of immunity. Nature 232:230-235, 1971 4. Good RA: Relations between immunity and malignancy. Proc Natl Acad Sci USA 69: 1026-1032, 1972 5. Hildemann WH: Some new concepts in immunological phylogeny. Nature 250:116-120, 1974 6. Humphreys TD: Specificity of aggregation in porifera. Transplant Proc 2:194-198, 1970 7. Kersey J, Sabad A, Gajl-Peczalska K, et al: Acute lymphoblastic leukemic cells with markers of T (thymus-derived) lymphocytes. Science 182:1355-1356, 1973 8. Kersey J, Spector B, Good RA: Immunodeficiency and cancer. Adv Cancer Res 18: 211-230, 1973 9. Kersey J H , Spector BD, Good RA: Primary immunodeficiency diseases and cancer, T h e Immunodeficiency-Cancer Registry. Int J Cancer 12:333-347, 1973 10. Kersey J, Spector BD, Good RA: Cancer in children with primary immunodeficiency disorders. J Pediatr 84:263-264, 1974 635 11. Luckasen JR, White JG, Kersey J H : Mitogenic properties of a calcium ionophore, A23187. Proc Natl Acad Sci USA 71:5088-5090, 1974 12. Marquardt M: Paul Ehrlich. London, William Heinemann Medical Books Ltd., 1949 13. Moscana A: T h e development in vitro of chimeric aggregates of dissociated embryonic chick and mouse cells. Proc Natl Acad Sci USA 43:184, 1957 14. Page AR, Hansen AE, Good RA: Occurrence of leukemia and lymphoma in patients with agammaglobulinemia. Blood 2 1 : 1 9 7 - 2 0 5 , 1963 15. Penn I, Starzel T: Immunosuppression and cancer. Proc Fourth Congr Transpl Soc/abstr 220: 1972 16. Reed PW: A23187: A divalent cation ionophore (abstr). Fed Proc 31:432, 1972 17. Steinhardt RA, Epel D: Activation of sea urchin eggs by a calcium ionophore. Proc Natl Acad Sci USA 71:1915-1919, 1974 18. Stutman O: T u m o r development after 3-methylcholanthrene in immunologically deficient athymic-nude mice. Science 183:534-536, 1974 19. Theodor JL: Distinction between "self" and "not-self" in lower invertebrates. Nature 227:690-692, 1970 20. Whitney RB, Sutherland RM: Requirement for calcium ions in lymphocyte transformation stimulated by phytohemagglutinin. J Cell Physiol 80:329-337, 1972 21. Whitney RB, Sutherland RM: Enhanced uptake of calcium by transforming lymphocytes. Cell Immunol 5:137-147, 1972