T. Saito et al., Spontaneous ex vivo apoptosis of peripheral blood mononuclear cells in patients with head and neck cancer, CLIN CANC R, 5(6), 1999, pp. 1263-1273
Proportions of apoptotic (TUNEL+) peripheral blood mononuclear cells (PBMCs
) were measured by flow cytometry in patients with head and neck cancer and
normal controls at the time of blood draws (0 time) and after 24-h incubat
ion, PBMCs were incubated at 37 degrees C in medium (spontaneous apoptosis)
and in the presence of CH-11 antibody (anti-Fas) or tumor necrosis factor
(TNF)-alpha, both capable of inducing DNA fragmentation in activated T cell
s expressing the TNF family of receptors, PBMCs obtained from the patients
had significantly higher (P < 0.0001) proportion of apoptotic cells than PB
MCs of controls at 0 time as well as after 24-h incubation. Ex vivo apoptos
is included all subsets of PBMCs: CD3(+) T cells, CD16(+)CD56(+) natural ki
ller cells, CD19(+) B cells, and CD14(+) monocytes, as determined by two-co
lor flow cytometry, However, T cells represented the largest PBMC subset un
dergoing apoptosis, and lymphocytes rather than monocytes were the major TU
NEL+ PBMC population. Among T cells, the level of spontaneous ex vivo apopt
osis was nearly as high as that of CH-11 antibody-induced or TNP-alpha-indu
ced apoptosis, indicating that activated Fas(+) and TNFR1(+) T cells were p
reprogrammed in vivo to die. Also, elevated levels of spontaneous apoptosis
at time 0 in patients with head and neck cancer (P < 0.0001) indicated tha
t a higher fraction of PBMCs was undergoing apoptosis in vivo in patients t
han controls, Together, the data suggest that an increased rate of turnover
of lymphocytes is associated with cancer and may be responsible for functi
onal lymphocyte imbalance, even in treated patients who have no evident dis
ease.