In Vitro Lymphocyte Response of Patients with Immunologic Deficiency Diseases

Patients with congenital thymic aplasia are unable to manifest delayed hypersensitivity in vivo and in vitro, but usually possess normal levels of immunoglobulins. Patients with X-linked agammaglobulinemia, however, exhibit normal delayed hypersensitivity in vivo, but in vitro studies of lymphocyte transformation have been conflicting. An assay of macrophage migration inhibitory factor, shown to correlate with in vivo delayed hypersensitivity in the guinea pig, has recently been adapted for use in man. This assay shows that lymphocytes from agammaglobulinemic patients with normal delayed hypersensitivity respond to specific antigenic challenge by the production of migration inhibitory factor. However, lymphocytes from patients who fail to manifest delayed hypersensitivity in vivo fail to produce this factor in response to antigenic challenge in vitro. Furthermore, lymphocytes from a patient with congenital thymic aplasia produced the factor after a thymic transplant.