Regulation of IgM production in thermally injured patients.

This report examines the capacity of autologous and exogenous interleukin-2 (IL2) to regulate and/or induce immunoglobulin M (IgM) production in these patients. Pokeweed mitogen (PWM)-induced lymphocyte proliferation and PWM- and IL2-induced IgM secretion were monitored in vitro during the postburn period (10 to over 60 days) in 40 patients aged 16-72 years, with burns 20-90 per cent TBSA. PWM-induced IgM secretion fluctuated considerably during this period. Twelve of 40 patients demonstrated no IgM production and a significant (P less than 0.001-0.05) proportion of them had profoundly suppressed levels. Of the survivors, restoration of IgM secretion to normal levels was achieved in only 60 per cent at time of discharge. Even more consistently suppressed was exogenous IL2-driven production of IgM. In contrast, PWM-induced lymphoproliferation was normal in over 70 per cent of the patients. Thus, the T-cell-dependent antibody response was suppressed for long periods of time, possibly from some deficiency in IL2-regulated secretion or reception of helper T-cell-derived factors necessary for B cell differentiation into Ig-secreting cells.