Infection is a frequent complication and cause of death in renal failure, but the association between uremia, depressed immune status, and susceptibility to infection is far from proven. In the present studies, the effect of uremia on the inflammatory response and phagocytic ability was investigated in an animal model. The inflammatory response, as measured by the ability of leukocytes to mobilize into subcutaneous implanted sponges, was impaired at 6 hr but was normal 24 hr after implantation. The peripheral blood response of uremic animals to the leukocytosis promoting protein from Bordetella pertussis was similar to that of control animals. Reticuloendothelial clearance of labelled albumin was unimpaired but catabolism of this substance was reduced significantly in uremic animals. The ability of the uremic host to clear an intravenous challenge of virus was also depressed. Phagocytic and bactericidal capability of polymorphonuclear (PMN) leukocytes, measured in vitro by latex ingestion and phagocytosis and killing of Staphylococcus aureus, was normal. PMN phagocytic function in vivo was determined by the clearance of viable Escherichia coli from subcutaneously implanted sponges and no significant difference between control and uremic groups was found. These studies have further defined the effect of uremia on immune mechanisms and support our contention that uremia per se is not a major factor contributing to the compromised immune status in this host.
Summary
A nude mutant (rnunz) arose spontaneously in a colony of Wistar albino rats (the wild‐type strain) in Wellington, New Zealand. On gross examination no thymus could be found in the mediastina of young animals, whereas in older mutants lobules of fatty tissue mimicked the appearance of the thymus of the wild‐type strain. Lymph nodes from the rnunz strain showed a marked lymphocyte depletion in the thymus‐dependent para‐cortical region of the node. Peyer's patches from the nude animals also showed a reduced density of small lymphocytes in the interfollicular zones. In the spleen, tissue from the reticular framework surrounding individual arterioles was sometimes completely empty of lymphocytes but the degree of depletion varied. Total leucocyte numbers in the rnunz strain were 28% lower than the wild‐type strain. In 10 out of 13 animals T cells were less than 3% of the lymphocytes present (wild‐type 35% T cells). The findings are in agreement with studies of the Rowett nude rat (rnu) and the nude mouse.
Leukaemic transformation of essential thrombocythaemia is a rare event and is usually associated with previous treatment with either alkylating agents or radioactive phosphorous. We describe a patient with essential thrombocythaemia who developed an acute leukaemia of T cell phenotype following hydroxyurea therapy. The T cell phenotype of the blasts suggests the target cell for leukaemic transformation was a pluripotential stem cell.
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