Lopez C, Simmons R L, Park B H, Najarian J S, Good R A
Clin Exp Immunol. 1974 Apr;16(4):565-73.
Cell-mediated and humoral immune responses were determined in immunosuppressed renal transplant recipients. A micro-phytohaemagglutinin (PHA) stimulation test utilizing whole heparinized blood and a macro-PHA test utilizing separated, washed lymphocytes were used to study cell-mediated immunity. Humoral immune status was estimated by determining quantitative immunoglobulins and complement fixing (CF) antibody titres to cytomegalovirus (CMV) infection. Micro-PHA responses were found to be markedly depressed in patients undergoing immunosuppressive therapy and in patients with chronic uraemia. Macro-PHA responses were normal, indicating that serum factors were responsible for the depressed micro-PHA responses. Antibody responses to CMV infections were found to be ten to a hundred times higher than in normal persons. An inverse relationship was demonstrated between micro-PHA responses and peak CF antibody titres to CMV infections. Humoral immune responses appeared to compensate for depressed cell-mediated immunity as measured by the micro-PHA test. Four patients had very low micro-PHA responses, did not respond to their CMV infections with CF antibody, and died of mixed bacterial and viral infections. Serum immunoglobulins of two were studied and were shown to be greater than two standard deviations below the normal mean. These patients appeared more suppressed than other patients receiving similar therapy and thus probably retained higher concentrations of suppressive drugs.
在免疫抑制的肾移植受者中测定了细胞介导免疫反应和体液免疫反应。采用利用全肝素化血液的微量植物血凝素（PHA）刺激试验以及利用分离、洗涤淋巴细胞的大量PHA试验来研究细胞介导免疫。通过测定针对巨细胞病毒（CMV）感染的定量免疫球蛋白和补体结合（CF）抗体滴度来评估体液免疫状态。发现在接受免疫抑制治疗的患者和慢性尿毒症患者中，微量PHA反应明显降低。大量PHA反应正常，表明血清因子是微量PHA反应降低的原因。发现对CMV感染的抗体反应比正常人高10到100倍。在微量PHA反应与针对CMV感染的CF抗体滴度峰值之间显示出负相关关系。通过微量PHA试验测定，体液免疫反应似乎补偿了细胞介导免疫的降低。4名患者微量PHA反应非常低，对CMV感染没有产生CF抗体反应，并死于混合细菌和病毒感染。研究了其中2名患者的血清免疫球蛋白，结果显示其低于正常均值两个标准差以上。这些患者似乎比接受类似治疗的其他患者受到的抑制更严重，因此可能体内保留了更高浓度的抑制药物。
