Antibody response to xenogeneic proteins in burned patients receiving cultured keratinocyte grafts

Cultured keratinocytes (CK) have been used to resurface large burn wounds with some success. These CK are grown in the presence of fetal bovine serum (FBS) and mouse fibroblasts (MF). Serum from ten patients who received CK grafts as part of burn wound coverage was studied by ELISA technique for antibody to these xenogeneic antigens. All patients had some amount of antibody to FBS but no detectable antibody to MF. The amount of antibody to FBS varied between patients and with respect to time after graft application. Generally, the levels of antibody to FBS were moderate by 30 days, declined, and then rose slowly by 5 to 6 months. The majority of antibody to FBS was against bovine serum albumin (BSA), demonstrated by Western blot technique. The presence of such antibody to FBS might produce clinical problems of graft rejection, anaphylaxis, and serum sickness in patients receiving CK grown in FBS supplemental medium. Further investigation will need to determine the likelihood and potential severity of such clinical problems.