Lymphocyte function in anergic patients.

The lymphocyte function of anergic surgical patients who are at increased risk for sepsis and mortality was studied. In vitro lymphocyte responses appear to be normal in most instances, in that over 80% of patients showed a normal response in a standardized mixed leucocyte culture reaction. Similarly, 56% of the lymphocytes from anergic patients showed a positive in vitro proliferative response with PPD. The ability of in vitro-activated lymphocytes to elicit a skin reaction was determined by culturing the cells of anergic patients with PPD and then reinjecting the lymphocytes or their supernatants intradermally into the original donor. When there was a positive proliferative response to PPD in vitro, the reinjected cells or supernatant elicited a positive skin reaction in 79% of the anergic patients. In contrast, a skin reaction was obtained in less than 20% of the instances when there was no in vitro proliferation to PPD or when the cells were cultured without antigen. These results suggest that one of the acquired immune defects in these anergic patients is an in vivo block of lymphocyte activation.