Polyclonal immunoglobulin production in burned patients--kinetics and correlations with T-cell activity

Spontaneous and pokeweed mitogen (PWM)-induced polyclonal immunoglobulin production in vitro were estimated in patients with severe burns (28-83% TBSA) immediately following their injury and at intervals of 8 to 14 days thereafter. In parallel, functional activity of patients' T lymphocytes was assessed in the mixed lymphocyte reaction (MLR). PWM-induced immunoglobulin secretion, of both IgG and IgM, was elevated in the first 2 to 3 weeks after burn, followed by a period of relatively suppressed antibody response at 3 to 4 weeks. Immunoglobulin production was then apparently restored to baseline or higher levels in surviving patients. However, in patients whose antibody response continued to be suppressed fatal septicemia developed. The background (spontaneous) immunoglobulin synthesis increased significantly over the normal range in 10/78 tests performed. These alterations in mitogen-induced immunoglobulin production were well correlated with changes in the T-cell alloreactivity in the MLR. Thus thermal injury-associated changes in the patients' humoral responses may be a consequence of changes within the T-cell compartment, especially the T-helper cell subset.