Diagnostic and Therapeutic Immunology of Renal Cell Cancer

There is evidence that renal cell carcinoma can alter the host immunologic system in several modalities. Diagnostic immunologic monitoring techniques reviewed in this report include delayed cutaneous hypersensitivity reaction (DCHR), absolute peripheral lymphocyte count (APLC), lymphocyte mitogen response (LMR), T-lymphocyte population (erythrocyte rosette), microcytotoxicity assay, in vitro monocyte chemotaxis, and serum blocking factors. Therapeutic immunologic modalities include xenogeneic immune ribonucleic acid (RNA), intradermal BCG, preoperative transcatheter renal artery embolization, immune plasma transfusion, transfer factor, and polymerized autologous tumor

Minimally Invasive Therapies for Hepatocellular Carcinoma: Mechanisms of Local Control and Systemic Immunologic Response

Minimally invasive treatments for hepatocellular carcinoma (HCC) are a cornerstone in the management of this challenging disease. For many years, percutaneously guided ablative techniques, such as radiofrequency ablation (RFA), cryoablation, and microwave ablation (MWA), have successfully treated many different solid malignancies including HCC. Since the initial implementation of these ablative techniques, there have been many advances in the design, technique, and patient selection as well as investigation into the body’s response to treatment. The mechanisms of thermal-based ablative techniques, advantages and disadvantages of each technique, subsequent immunologic response following ablation, and advances in care that utilize combination therapy to potentiate the immunologic response creating a robust and long-term immunity to HCC are outlined in this chapter

On the unlikelihood of specific long range forces in immunologic and enzymatic reactions

In the past few years, a great many experiments have been performed by Rothen (24, 25) which he has interpreted as suggesting that antigen and antibody, and enzyme and substrate proteins, can react specifically, although separated by distances of hundreds of angstroms. This hypothesis seems to conflict with evidence accumulated from many other investigations indicating that short range interactions, involving distances usually associated with electrostatic and van der Waals’ forces, and hydrogen bonds, of the order of 5 A, operate in these reactions. We have therefore engaged in a critical analysis of the experimental techniques used by Rothen to determine whether some interpretation other than that invoking the existence of specific long range forces could be found to explain his experimental results

The changing immunology of organ transplantation

The engrafted organ becomes a chimera as the recipient's leukocytes station themselves in the transplant. Remarkably, the recipient becomes chimeric as well, in a reverse migration involving immune cells from the graft. Interactions between donor and recipient cells are tolerogenic-a process with implications for the goal of graft acceptance with minimal immunosuppression

Thoracic duct drainage before and after cadaveric kidney transplantation

Twenty-seven consecutive recipients of cadaveric kidneys, including five with pre-existing warm cytotoxic antibodies, were treated with thoracic duct drainage before and after transplantation. Fourteen patients who had lymph drainage for 26 to 58 days before transplantation had minor cytotoxic antibody responses after grafting, even if the antibodies had been present before therapy. Only one of the 14 recipients had any rejection during the follow-up periods of one to six months. There were two deaths. The 13 patients pretreated for 17 to 23 days exhibited stronger cytotoxic antibody responsiveness, and five of these recipients had significant rejections of which four were reversible. One of the latter 13 patients died. These clinical and immunologic studies have established the value and have defined the appropriate timing of preoperative thoracic duct drainage in kidney transplantation. They have also directed attention to the rationale and the probable value of using other immunosuppressive methods for preparatory host conditioning instead of beginning such therapy at the time of transplantation