Using a sensitive enzyme-linked immunosorbent assay technique to measure immunoglobulins produced by peripheral lymphocytes, patients with cirrhosis with, and without, hypergammaglobulinaemia were found to produce significantly more spontaneous IgG than controls (p less than 0.005). There was no difference in IgG production when pokeweed mitogen, a T-cell dependent B-cell mitogen, was added to the system. Contrary to our findings in a T-cell proliferative assay, there was no evidence of increased prostaglandin-producing suppressor cell activity in this system. To study the importance of B-cell stimulation in cirrhotic hyperglobulinaemia, normal mononuclear cells were exposed either to cirrhotic or to control sera before measuring spontaneous IgG production. Cells exposed to cirrhotic sera produced significantly more IgG than those exposed to the control sera (p less than 0.02). These findings suggest that non-specific B-cell activity occurs with patients in cirrhosis and it is argued that the severity of the hypergammaglobulinaemia in patients with cirrhosis is more likely to depend on the degree of non-specific B-cell stimulation than on the competence of the immunoregulatory system.
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