The “In Vitro Skin Test”

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Abstract
In vitro blast transformation of human peripheral lymphocytes was tested using standard skin test antigens, the mitogens PHA [phytohemagglutinin] and Con A [concanavalin A] and the mixed lymphocyte reaction, 15 patients with multiple trauma, 40 with major burns, 6 following cholecystectomies, 6 following aortic reconstruction and 30 normal volunteer controls. Repeated skin testing may sensitize patients to Candida and streptokinase-streptodornase (SKSD) and desensitize them to mumps antigen. Blast transformation in response to PPD [purified protein derivative] did not correlate with the clinical status of the patients. Blast transformation in response to stimulation by the mitogens PHA and Con A could not reliably predict the occurrence of septic complications. Reactivity in response to stimulation by the soluble antigens SKSD and mumps and in the 1-way mixed lymphocyte reaction accurately predicted the clinical course of patients. This method of in vitro skin testing is a reliable and repeatable method of monitoring the immunologic status of patients whose illness or injury requires longitudinal study.