Immunoglobulin production in vitro by peripheral blood lymphocytes in systemic lupus erythematosus: helper T cell defect and B cell hyperreactivity.

Peripheral blood lymphocytes (PBL) from 16 patients with systemic lupus erythematosus (SLE) and 15 healthy control subjects were cultured and immunoglobulin (Ig) production in vitro was measured by immunofluorescent staining for intracytoplasmic Ig, a reverse haemolytic plaque assay to quantify cells secreting Ig and a solid-phase radioimmunoassay for Ig secreted into culture supernatants. Compared with normal PBL, lymphocytes from patients with SLE produced significantly fewer Ig-containing cells, Ig-secretion cells (ISC) and less Ig in supernatants in cultures stimulated by pokeweed mitogen (PWM). These differences were most pronounced during phases of disease activity. Culturing SLE PBL with a supernatant obtained from PWM-activated cultures of normal T lymphocytes partially restored their capacity to produce ISC. This observation suggests a helper T cell defect of SLE lymphocytes. In addition, PBL from patients with active SLE generated more ISC when cultured with Staphylococcus aureus bacteria (S aureus) than with PWM. S. aureus-stimulated cultures of SLE PBL also generated more ISC than PBL from normal individuals. The S. aureus response of SLE lymphocytes did not correlate with disease activity. As S. aureus is a T cell-independent mitogen, the latter observations suggest that in SLE an intrinsic B cell hyperreactivity may be a more persistent defect whereas T cell defects are transitory.