Abstract • The effects of prophylactic administration of intravenous IgG on immune-cell phenotype and function in burn patients were compared with those of patients receiving standard therapy. Intravenous IgG infusions were given twice weekly for three weeks postburn or until wound closure. Intravenous IgG had no effect on the proportion of total T-lymphocytes, T-helper lymphocytes, or T-suppressor lymphocytes, but the proportion of B-lymphocytes decreased 40% in treated patient samples. Lymphocytes from treated patients incorporated less thymidine when stimulated with concanavalin A or pokeweed mitogen, but not with phytohemagglutinin. The amount of IgM secreted by pokeweed mitogen-stimulated cultures from treated patients increased by 24%, while the amount of IgG remained constant. The changes in β-lymphocyte number and functional response may have been induced by the increased serum IgG levels in the intravenous IgG—treated patients. (Arch Surg 1988;123:1379-1382) References 1. Buckley RH: Immunoglobulin replacement therapy: Indications and contraindications for use and variable IgG levels achieved , in Alving BM (ed): Immunoglobulins: Characteristics and Uses of Intravenous Preparations . Washington, DC, US Government Printing Office, 1980, pp 3-8. 2. Nolte MT, Pirofsky B, Gerritz GA, et al: Intravenous immunoglobulin therapy for antibody deficiency . Clin Exp Immunol 1979;36:237-243. 3. Ochs HD, Davis SD, Wedgewood RJ: Intravenous gamma globulin (IVGG) therapy in immunodeficiency syndromes , abstracted. Clin Res 1974;122-124A. 4. McManus AT, Missavage AE, McManus WF, et al: Intravenous immune globulin does not reduce infections or alter mortality in seriously burned patients. Program and abstracts of the Fifth International Symposium on Infections in the Immunocompromised Host. Noordwijkerhout, the Netherlands, June 5-9, 1988. 5. Sevitt S: A review of the complications of burns, their origin and importance for illness and death . J Trauma 1979;19:358-369.Crossref 6. Munster AM: Immunologic response of trauma and burns: An overview . Am J Med 1984;76:142-145.Crossref 7. Alexander JW, Ogle CK, Stinnett JD, et al: A sequential, prospective analysis of immunologic abnormalities and infection following severe thermal injury . Ann Surg 1978;188:809-816.Crossref 8. Antonacci AC, Reaves LE, Calvano SE, et al: Flow cytometric analysis of lymphocyte subpopulations after thermal injury in human beings . Surg Gynecol Obstet 1984;159:1-8. 9. Mclrvine AJ, O'Mahony JB, Saporoschetz I, et al: Depressed immune response in burn patients: Use of monoclonal antibodies and functional assays to define the role of suppressor cells . Ann Surg 1982;196:297-304.Crossref 10. O'Mahoney JB, Wood J, Rodrick ML, et al: Changes in T lymphocyte subsets following injury: Assessment by flow cytometry and relationship to sepsis . Ann Surg 1985;202:580-586.Crossref 11. Arturson G, Hogman CF, Johansson SG, et al: Changes in immunoglobulin levels in severely burned patients . Lancet 1969;1:546-548.Crossref 12. Munster AM, Hoagland HC, Pruitt BA Jr: The effect of thermal injury thermal serum immunoglobulins . Ann Surg 1970;172:965-969.Crossref 13. Fjellstrom KE, Arturson G: Changes in the human complement system following burn trauma . Acta Pathol Microbiol Scand 1963; 59:257-270.Crossref 14. Bjornson AB, Altemeier WA, Bjornson HS: Changes in humoral components of host defense following burn trauma . Ann Surg 1977;186:88-96.Crossref 15. Engleman EG, Benike CJ, Metzler C, et al: Blocking of human T lymphocyte functions by anti-Leu-2 and anti-Leu-3 antibodies: Differential inhibition of proliferation and suppression . J Immunol 1983;130:2623-2628. 16. Fanger MW, Reese AC, Schoenberg MD, et al: Evidence for T lymphocyte subpopulations in the rabbit . J Immunol 1974;112:1971-1980. 17. Raffel C, Sell S: The relationship between endocytosis of concanavalin A and phytohaemagglutinin receptors and blast transformation and direct identification of individual rabbit lymphocytes reactive to both mitogens . J Cell Sci 1982;56:141-156. 18. Burleson DG, Yballe-Calvo A, Villarreal Y, et al: Measurement of in vitro function of B lymphocyte from burned patients, abstract No. 22. Program and abstracts of the 20th Annual Meeting of the American Burn Association, Seattle, March 23-26, 1988.
Archives of Surgery – American Medical Association
Published: Nov 1, 1988