It has previously been shown by this laboratory that immunomodulation of thermally injured animals with low-dose interleukin-2 (IL-2) and indomethacin (Indo) improves survival following septic challenge. Lymphokine-activated killer (LAK) cells have been shown to be effective in certain viral infections and to act in synergy with IL-2 in the treatment of certain types of cancer. We have studied the effect of LAK cells in combination with IL-2 and Indo in a murine model of thermal injury and sepsis. Male A/J mice received a 25% scald burn injury or sham burn and were randomized into five groups: (a) sham/vehicle, (b) burn/vehicle, (c) burn/IL-2 (250 U) + Indo (5 μg), (d) burn/LAK cells (2 × 106 cells), or (e) burn/LAK cells + IL-2 + Indo and were treated accordingly for 6 days following injury. LAK cells were generated by in vitro IL-2 treatment of syngeneic spleen cells for 72 hr and cytotoxic activity was confirmed by standard 51Cr release assay using natural killer (NK)-sensitive and NK-resistant targets. In the groups receiving LAK cells they were administered on Day 1 and Day 6 postinjury. On Day 10, septic challenge by cecal ligation and puncture (CLP) or splenectomy, for in vitro studies, was performed. Five-day survival after CLP was 80% in the sham/vehicle group compared to 0% in the burn/vehicle group (P < 0.01). IL-2/Indo and LAK/IL-2/Indo improved survival to 25% (P < 0.05) and 57.1% (P < 0.01), respectively. In vitro lymphocyte IL-2 production in response to mitogens was increased in the LAK/IL-2/Indo group compared with the burn/vehicle group (3 U/ml vs 2 U/ml, respectively, P < 0.05). IL-2/Indo alone had no significant effect on these in vitro parameters. As shown previously, monokine (IL-1, IL-6, and TNF) secretion by adherent splenocytes in response to LPS was markedly increased following thermal injury; no change was observed with any of the therapeutic protocols. We conclude that combined LAK/IL-2/Indo therapy is an effective regime for reduction of sepsis-related mortality and that LAK cells act synergistically with IL-2 to improve in vitro parameters of immune function in this model.
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