The primary immune response to haemocyanin in patients with primary biliary cirrhosis.

Both the humoral and cellular immune response to haemocyanin was measured in normal subjects and patients with liver disease including primary biliary cirrhosis, other forms of cholestasis, and cryptogenic cirrhosis. Significant differences in antibody titre were found 2 weeks after immunization being highest in normal subjects, less in cryptogenic cirrhosis and least in primary biliary cirrhosis. The incidence of positive skin tests, indicating the development of delayed hypersensitivity to haemocyanin, was significantly less in patients with primary biliary cirrhosis and cryptogenic cirrhosis than in those with cholestasis or the normal subjects. It is suggested that the poor antibody response seen in primary biliary cirrhosis, could be related to impaired T cell function and hence lack of the T and B cell co-operation necessary for antibody formation to some antigens. The presence of delayed hypersensitivity to haemocyanin as measured by the skin test was compared to other tests of delayed hypersensitivity including the tuberculin skin test, DNCB sensitization and PHA-stimulated lymphocyte transformation. Of twenty patients with primary biliary cirrhosis the results of all four tests correlated in nine but did not agree in the remaining eleven patients. These results emphasize the importance of using a number of indices when assessing the degree of anergy of any one patient.