Abnormalities of antibody production after thermal injury. An association with reduced interleukin 2 production
J. J. Wood, J. B. O'Mahony, M. L. Rodrick, R. Eaton, R. H. Demling and J. A. Mannick
Antibody (Ab) production was studied in 25 burned patients who were
immunized with 0.5 mg of tetanus toxoid adsorbed. Anti-tetanus toxoid (TT)
Ab was measured by hemagglutination, radial immunodiffusion, and an
enzyme-linked immunosorbent assay, and the results for the patients were
compared with those for five similarly immunized healthy controls. As
measured by hemagglutination, 12 (63%) of 19 patients had lower Ab
responses than all five controls (P less than .05 by chi 2), and the median
Ab response during the period of maximum response was significantly less
than that in controls (8 vs 15.5 log2 maximum dilution; P = .014). After
the initial response, serum Ab levels were not maintained in patients, in
contrast to controls. This pattern was demonstrated by all three assays;
enzyme-linked immunosorbent assay demonstrated that IgG anti-TT Ab was the
major class of Ab produced. In nine patients interleukin 2 production by T
lymphocytes was measured simultaneously; it was significantly depressed
throughout the study except during the period from 36 to 45 days. The Ab
response was also impaired in this patient group. Since maintained antibody
production in response to TT is known to be T-cell dependent, these results
suggest that inadequate interleukin 2 production leading to reduced T-cell
help may be responsible for the lack of a persistent Ab response in these
burned patients.
