A population of lymphocytes attacks nucleated target cells in the presence of antitarget cell antibody. The cells are known as "killer" (K) cells and the reaction is known as antibody-dependent cellular cytotoxicity. We determined K-cell activity in 70 critically ill surgical patients in order to determine its value in predicting death or survival. Lymphocytes were obtained from the peripheral blood of the patients; murine P-815 mastocytoma cells were used as target cells and antimastocytoma cell IgG antibody was prepared in the rabbit. The initial value of K-cell activity was decreased by 58% in patients who later died; the value was normal in survivors. In septic patients, the decrease was the same in those who lived and those who died. The final value was 64% lower than the initial value in those who died. Therefore, a low initial value and further decrease signified the likelihood of death. Peripheral nutritional alimentation had no effect on K-cell activity. Central alimentation produced a sixfold increase in patients who had > 50% decrease before treatment, but had no effect in those who had normal activity initially. It was concluded that K-cell activity of peripheral blood lymphocytes is a sensitive indicator of the immune status of surgical patients, that it is useful in monitoring the course of the disease, and that central alimentation causes an increase in immunosuppressed patients.
Adolescent Adult