Effect of adult thymectomy on the development of 1-chloro-2,4-dinitrobenzene contact sensitivity and other T lymphocyte functions in patients with myasthenia gravis.

1-Chloro-2,4-dinitrobenzene (DNCB) contact sensitivity and other T lymphocyte functions were studied in thymectomized and non-thymectomized patients with myasthenia gravis. The ability to develop contact sensitivity was reduced in patients with myasthenia gravis and was further reduced after thymectomy. Memory lymphocyte function, as measured by skin tests with common microbial antigens, was intact. A positive phytohemagglutinin (PHA) skin test was found mainly in those patients who also developed contact sensitivity to DNCB. The number of rosette-forming T cells in the peripheral blood as well as mitogen stimulation with PHA was found to be normal in thymectomized as well as non-thymectomized patients. In the thymectomized group, mitogen stimulation with concanavalin A and staphylococcal protein A was also within the normal range, while increased stimulation was obtained with pokeweed mitogen (PWM) and purified protein derivative (PPD). No alteration in mixed lymphocyte culture reactivity or immunoglobulin levels was obtained compared with healthy blood donors. On the basis of these results, it is concluded that non-thymectomized as well as thymectomized patients with myasthenia gravis may have a defective subpopulation of T cells possibly residing in the TH1-positive population. Furthermore, the increased lymphocyte stimulation obtained with PPD and PWM may indicate a reduction of suppressor cell activity after thymectomy.