Cytotoxic killing of 51Cr-labeled Chang cells (direct cytotoxicity) by isolated peripheral blood mononuclear cells has been tested in normal individual and patients transplanted with a cadaveric renal graft receiving immunosuppressive therapy. Cytotoxicity in the presence of phytohemagglutinin (PHA cytotoxicity) was also measured in some patients. Control values for direct cytotoxicity assays obtained in patients with stable renal function did not significantly differ from results in normal individuals. In contrast, control values for PHA cytotoxicity were significantly depressed. In the course of graft rejection episodes, both direct and PHA cytotoxicity were significantly increased compared to control values. Direct cytotoxicity was also increased during an intercurrent infection although the increase was less than that observed in patients undergoing graft rejection. These results suggest that during graft rejection a host immune reponse to an allogeneic stimulus results in the generation of effector cells which cause cytotoxic killing of Chang target cells in vitro, although the specificity of the killing reaction remains to be established. Cytotoxic cells may also be generated as a result of intercurrent infection in vivo.
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