Natural cell-mediated cytotoxicity in normal human peripheral blood lymphocytes and its in vitro boosting with BCG

Natural cell-mediated cytotoxicity (NCMC) against K-562 human erythroleukemic cells was monitored in an overnight chromium release assay using normal human peripheral blood lymphocytes (PBL) as effective cells. Two hundred and ten normal individuals were tested from 3 to 24 times over a period of 3 years. The level of NCMC was shown to vary from 4% to 46% lysis at an effector-to-target cell ratio of 5/1; males had higher levels of activity than females (P less than 0.001). A group of individuals with low natural killer (NK) cell activity (below the 90% tolerance limit) was identified in replicate experiments and 60% of them were young women (ages 20--39). In vitro boosting of NK activity with Bacillus Calmette-Guérin (BCG) was also studied; overall, 56% of normal individuals responded positively to BCG. There was a significant (P less than 0.001) correlation between the unstimulated level of NCMC and the in vitro boosting with BCG, as 63% of individuals with a normal level of NK activity could be boosted as against only 19% of persons with low NK activity. We have also established the in vivo relevance of this in vitro test by determining the degree of correlation between responses to in vitro boosting with BCG and a positive or negative reaction in a hypersensitivity skin test using 5 IU of PPD (purified protein derivative of BCG). Our results indicate that NCMC is an individual trait that varies little under physiological conditions, and that the response to BCG is a characteristic property of the effector lymphocyte, depending primarily on the unstimulated level of NCMC.