Abstract
There remains a great need in medicine for new immunosuppressive therapies that are capable of suppressing disease activity but are not associated with the complications of general cytotoxicity and nonselective immunosuppression. Currently available immunosuppressive drugs are too frequently associated with serious and sometimes lethal complications. We review here the relatively unique immunologic changes associated with total lymphoid irradiation (TLI) and the development of this form of radiotherapy as an immunosuppressive treatment for rheumatic diseases.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Andrews, B. S., Eisenberg, R. A., Theofilipoulous, A. N., Izui, S., Wilson, C. B., McConahey, P. J., Murphy, E. D., Roths, J. B., and Dixon, F. J., 1978, Spontaneous murine lupus-like syndromes: Clinical and immunopathological manifestations in several strains,J. Exp. Med.148: 1198–1215.
Baccarini, M., Bosi, A., and Papa, G., 1980, Second malignancy in patients treated for Hodgkin’s disease,Cancer46: 1735–1740.
Coleman, C. N., Williams, C. J., Flint, A., Glatstein, E., Rosenberg, S. A., and Kaplan, H. S., 1977, Hematologic neoplasia in patients treated for Hodgkin’s disease,N. Engl. J. Med.297: 1249–1252.
Fauci, A. S., Whalen, G., and Burch, C, 1980, Activation of human B lymphocytes. XVI. Cellular requirements, interactions, and immunoregulation of pokeweed mitogen-induced total-immunoglobulin producing plaque-forming cells in peripheral blood,Cell. Immunol.54: 230–240.
Field, E. H., Strober, S., Hoppe, R. T., Calin, A., Engleman, E. G., Kotzin, B. L., Tanay, A. S., Calin, H. J., Terrell, C. P., and Kaplan, H. S., 1983, Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation,Arthritis Rheum. 26: 937–946.
Field, E. H., Engleman, E. G., Terrell, C. P., and Strober, S., 1984a, Reduced in vitro immune responses of purified human Leu-3 (helper/inducer phenotype) cells after total lymphoid irradiation.J. Immunol.132: 1031–1035.
Fuks, Z., Strober, S., Bobrove, A. M., Sasazuki, T., McMichael, A., and Kaplan, H. S., 1976, Long-term effects of radiation on T and B lymphocytes in peripheral blood of patients with Hodgkin’s disease, J. Clin. Invest. 58: 803–814.
Gottlieb, M., Strober, S., Hoppe, R. T., Grumet, F. C., and Kaplan, H. S., 1980, Engraftment of allogeneic bone marrow without graft-versus-host disease in mongrel dogs using total lymphoid irradiation,Transplantation29: 487–491.
Gottlieb, M., Strober, S., and Kaplan, H. S., 1981, Cellular basis of graft versus host tolerance in chimeras prepared with total lymphoid irradiation (TLI),J. Exp. Med.152: 736–741.
Helfgott, S., Brahn, E., Trentham, D., Belli, J., Anderson, R., Reinherz, E., Schlossman, S., and Austin, K. F., 1983, Long-term effects of total lymphoid irradiation in refractory rheumatoid arthritis,Arthritis Rheum. 26: S7.
Hess, A. D., and Tutschka, P. J., 1980, Effect of cyclosporin A on human lymphocyte responses in vitrol 1. Cs A allows for the expression of alloantigen-activated suppressor cells while preferentially inhibiting the induction of cytolytic effector lymphocytes in MLR,J. Immunol.124: 2601–2608.
Howie, J. B., andHelyer, B. J., 1968, The immunology and pathology of NZB mice,Adv. Immunol.9: 215–284.
Kaplan, H. S., 1980,Hodgkin’s Disease, ed. 2, Harvard University Press, Cambridge, Massachusetts.
Keightley, R. G., Cooper, M. D., and Lawton, A. R., 1976, The T cell dependence of B cell differentiation induced by pokeweed mitogen,J. Immunol.117: 1538–1544.
King, D. P., Strober, S., and Kaplan, H. S., 1981, Suppression of the mixed leukocyte response and of graft- versus-host disease by spleen cells following total lymphoid irradiation (TLI),J. Immunol.126: 1140–1145.
Kotzin, B. L., and Strober, S., 1979, Reveral of NZB/NZW disease with total lymphoid irradiation,J. Exp. Med.150: 371–378.
Kotzin, B. L., Strober, S., Engleman, E. G., Calin, A., Hoppe, R. T., Kansas, G. S., Terrell, C. P., and Kaplan, H. S., 1981, Treatment of intractable rheumatoid arthritis with total lymphoid irradiation,N. Engl. J. Med.305: 969–976.
Kotzin, B. L., Kansas, G. S., Engleman, E. G., Hoppe, R. T., Kaplan, H. S., and Strober, S., 1983a, Changes in T-cell subsets in patients with rheumatoid arthritis treated with total lymphoid irradiation,Clin. Immunol. Immunopathol.27: 250–260.
Kotzin, B. L., Ward, R., and Strober, S., 1983b, Failure of NZB/NZW spleen cells to re-establish disease in irradiated syngeneic recipients,Arthritis Rheum. 26: S75.
Kotzin, B. L., Strober, S., Kansas, G. S., Terrell, C. P., and Engleman, E. G., 1984, Suppression of pokeweed mitogen stimulated immunoglobulin production in patients with rheumatoid arthritis after treatment with total lymphoid irradiation,J. Immunol.132: 1049–1055.
Krikorian, J. G., Burke, J. S., Rosenberg, S. A., and Kaplan, H. S., 1979, Occurrence of non-Hodgkin’s lymphoma after therapy for Hodgkin’s disease,N. Engl. J. Med.300: 452–458.
Lowry, R. P., Forbes, R. D., and Blackburn, J. H., 1984a, Immune reactivity and immunosuppressive intervention (TLI) in experimental nephritis. 1. Immunopathologic correlates in the accelerated autologous form of nephrotoxic serum nephritis,J. Immunol.132: 1001–1006.
Lowry, R. P., Forbes, R. D., Carpenter, C. B., Gurley, K. E., and Merrill, J. P., 1984b, Immune reactivity and immunosuppressive intervention in experimental nephritis. 11. Effect of TLI on the course of two models of nephritis in the inbred rat,J. Immunol.132: 1007–1012.
May, R. D., Slavin, S., and Vitetta, E. S., 1983, The partial characterization of suppressor cells in the spleens of mice conditioned with fractionated total lymphoid irradiation (TLI),J. Immunol.131: 1108–1114.
Neale, T. J., and Wilson, C. B., 1982, Glomerular antigens in Heymann’s nephritis: Reactivity of eluted and circulating antibody,J. Immunol.128: 323–330.
Okada, S., and Strober, S., 1982, Spleen cells from adult mice given total lymphoid irradiation (TLI) or from newborn mice have similar regulatory effects in the mixed leukocyte reaction (MLR). 1. Generation of antigen-specific suppressor cells in the mixed leukocyte reaction after the addition of spleen cells from adult mice given total lymphoid irradiation,J. Exp. Med.156: 522–538.
Oseroff, A., Okada, S., and Strober, S., 1984, Natural suppressor (NS) cells found in the spleen of neonatal mice and of adult mice given total lymphoid irradiation (TLI) express the null surface phenotype,J. Immunol.132: 101–110.
Prud’homme, G. J., Park, C. L., Feiser, T. M., Kofler, R., Dixon, F. J., and Theofilopoulos, A. N., 1983, Identification of a B cell differentiation factor(s) spontaneously produced by proliferating T cells in murine lupus strains of the lpr/lpr genotype,J. Exp. Med.157: 730–742.
Reinherz, E. L., Morimoto, C., Penta, A. C., and Schlossman, S. F., 1980, Regulation of B cell immunoglobulin secretion by functional subsets of T lymphocytes in man,Eur. J. Immunol.10: 570–572.
Rosenberg, S. A., and Lipsky, P. E., 1979, Monocyte dependence of pokeweed mitogen-induced differentiation of immunoglobulin-secreting cells from human peripheral blood mononuclear cells,J. Immunol.122: 926–931.
Schurman, D. J., Hirshman, P., and Strober, S., 1981, Total lymphoid irradiation and local joint irradiation in the treatment of adjuvant arthritis,Arthritis Rheum. 24: 38–44.
Slavin, S., Strober, S., Fuks, Z., and Kaplan, H. S., 1976, Long-term survival of skin allografts in mice treated with fractionated total lymphoid irradiation,Science193: 1252–1255.
Slavin, S., Strober, S., Fuks, Z., and Kaplan, H. S., 1977, Induction of specific tissue transplantation tolerance using fractionated total lymphoid irradiation in adult mice: Long-term survival of allogeneic bone marrow and skin grafts,J. Exp. Med.146: 34–48.
Slavin, S., Reitz, B., Bieber, C. P., Kaplan, H. S., and Strober, S., 1978, Transplantation tolerance in adult rats using total lymphoid irradiation: Permanent survival of skin, heart and marrow allografts,J. Exp. Med.147: 700–707.
Strober, S., Tanay, A., Field, E., Hoppe, R. T., Calin, A., Engleman, E. G., Kotzin, B. L., Brown, B. W., and Kaplan, H. S., 1985a, Efficacy of total lymphoid irradiation in intractable rheumatoid arthritis: A double-blind randomized trial,Ann. Intern. Med.102: 441–449.
Strober, S., Field, E., Hoppe, R. T., Kotzin, B. L., Shemesh, O., Engleman, E., Ross, J. C., and Meyers, B. D., 1985b, Treatment of intractable lupus nephritis with total lymphoid irradiation,Ann. Intern. Med.102: 450–458.
Tanay, A., and Strober, S., 1984, Opposite effects of total lymphoid irradiation on T cell dependent and T cell independent antibody responses,J. Immunol.132: 979–984.
Tanay, A., Strober, S., Logue, G. L., and Schiffman, G., 1984, Use of total lymphoid irradiation (TLI) in studies of the T cell dependence of autoantibody production in rheumatoid arthritis,J. Immunol.132: 1036–1040.
Theofilopoulos, A. N., Balderas, R., Schawler, D. L., Izui, S., Kotzin, B. L., Strober, S., and Dixon, F. J., 1980, Inhibition of T cell proliferation and SLE-like syndrome of MRL/1 mice by whole body or total lymphoid irradiation,J. Immunol.125: 2137–2142.
Trentham, D. E., Belli, J. A., Anderson, R. J., Buckley, J. A., Goetzl, E. J., David, J. R., and Austen, K. F., 1981, Clinical and immunologic effects of fractionated total lymphoid irradiation in refractory rheumatoid arthritis,N. Engl. J. Med.305: 976–982.
Valagussa, P., Santoro, A., Kenda, R., Fossati Bellani, F., Franchi, F., Banfi, A., Rilke, F., and Bonadonna, G., 1980, Second malignancies in Hodgkin’s disease: A complication of certain forms of treatment,Br. Med. J.280: 216–219.
Zan-Bar, I., Slavin, S., and Strober, S., 1978, Induction and mechanism of tolerance to bovine serum albumin in mice given total lymphoid irradiation (TLI),J. Immunol.121: 1400–1404.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1985 Plenum Publishing Corporation
About this chapter
Cite this chapter
Kotzin, B.L., Strober, S. (1985). Total Lymphoid Irradiation. In: Gupta, S., Talal, N. (eds) Immunology of Rheumatic Diseases. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2493-5_30
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2493-5_30
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9509-9
Online ISBN: 978-1-4613-2493-5
eBook Packages: Springer Book Archive