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Development of antibodies to fetal calf serum with arthus-like reactions in
human immunodeficiency virus-infected patients given syngeneic lymphocyte
infusions
TA Selvaggi, RE Walker and TA Fleisher
Immunology Service, Warren Magnuson Clinical Center, National Institutes of
Health, Bethesda, MD 20892, USA.
In an attempt to restore immune competence to 12 human immunodeficiency
virus-1 (HIV-1)-infected patients, lymphocytes from their HIV-1- uninfected
identical twin siblings were cultured in medium supplemented with 5% fetal
calf serum (FCS), anti-CD3 antibody, and interleukin-2 (100 IU/mL) for 10
days and then infused into the patients. After multiple infusions, at 6- to
8-week intervals, half of the patients developed arthus-like reactions
within 4 to 12 hours of infusion consisting of fever > 39 degrees C,
hypotension, rigors, arthralgias, myalgias, headache, and/or malaise.
Preinfusion and postinfusion serum samples were evaluated for the presence
of antibodies to FCS using double immunodiffusion. All preinfusion serum
samples were negative by this method while 8 of the 12 patients developed
antibodies to a single component of FCS after two or more infusions of
lymphocytes cultured in FCS-supplemented medium. Prick skin testing to
standardized beef extract was negative in all patients. There was a
correlation between initial CD4 level and the development of antibodies to
FCS (median initial CD4 count in FCS antibody positive patients =
362.0/microL v median initial CD4 count of nonresponders = 135.0/microL).
There was no correlation with response to recall antigens in delayed-type
hypersensitivity testing. We conclude that selected patients were
sensitized to a single component of FCS carried on donor lymphocytes,
despite thorough washing of the cells before infusion. The development of
antibodies to FCS indicates that immune complex formation could have
occurred after the cell infusions, resulting in the arthus-like reactions.
These observations suggest that the therapeutic use of human lymphocytes
cultured in FCS may expose the recipient to immunogenic substances with
possible clinical sequelae.
Volume 89,
Issue 3,
pp. 776-779,
02/01/1997
Copyright © 1997 by The American Society of Hematology
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