Specific sensitization of Lyt-1+2- T cells to spleen cells modified by the drug D-penicillamine or a stereoisomer

A mouse model for assessing the sensitization of T cells to the drug D-penicillamine (D-Pen) has been established. Mice were primed with D-Pen in vivo and the secondary response of specific T cells was measured in a proliferative assay in vitro. Priming was achieved by injecting either free D-Pen or, more effectively, D-Pen in complete Freund's adjuvant at the base of the tail. After 7 to 9 days, the draining lymph node cells (responder cells) were restimulated in vitro with syngeneic spleen cells that had been preincubated with D-Pen for 20 to 22 hr and washed (D-Pen-SC). The thiol (-SH) group of D-Pen was required for generating effective stimulator cells; other thiol compounds, however, or heavy metals (Hg, Au) were unable to generate cross-reacting stimulators on incubation with spleen cells. Although D-Pen-SC proved to be good stimulator cells, thymocytes and mouse erythrocytes, after having been preincubated with D-Pen, completely failed to stimulate. The proliferating responder cells were Lyt-1+2- T cells that were highly specific for D-Pen-SC and were even capable of distinguishing between the two stereoisomers D-Pen and L-Pen. The splenic T cells of recipient mice were effectively primed by injecting D-Pen-SC, but not free D-Pen, via the i.v. route. These findings indicate that D-Pen can act as a hapten for specific T cells when presented on the surface of appropriate stimulator cells. Conceivably, if D-Pen were able to generate effective stimulator cells in vivo, this could lead to T cell reactions comparable to those in the graft-vs-host reaction (GVHR). We discuss the possibility that the GVH-like adverse immunologic side-effects of D-Pen in patients may have a GVHR-like pathogenesis.