Anergy, immunosuppressive serum, and impaired lymphocyte blastogenesis in burn patients
J. H. Wolfe, A. V. Wu, N. E. O'Connor, I. Saporoschetz and J. A. Mannick
Skin testing with four recall antigens was performed serially in 21
patients after a major thermal burn. We looked for a correlation between
the occurrence of anergy, the presence of immunosuppressive serum, and the
impairment of the lymphocyte-proliferative response to phytohemagglutinin
(PHA). Serum cortisol, endotoxin, and prostaglandin E2 (PGE2) levels were
also measured in the serum or plasma. When anergy developed, it became
apparent early in the course of the illness. It did not correlate closely
with the severity of the burn, but was associated with mortality. There was
a good correlation between anergy and coexisting serum suppression of
lymphocyte activation in vitro. This serum immunosuppressive activity was
not related to serum cortisol, PGE2, or plasma endotoxin levels. Anergy
also correlated with coexistent impairment of patient peripheral blood
lymphocyte activation by PHA. These results suggest that both
immunosuppressive serum and an impaired lymphocyte response to mitogens are
associated with anergy in burn patients and confirm that the development of
anergy is an index of poor prognosis.
