Complement, lymphocytotoxins and immune complexes in infectious mononucleosis: serial studies in uncomplicated cases.

Serial studies of complement, immunoglobulins, lymphocytotoxins and immune complexes were performed in thirteen patients with uncomplicated infectious mononucleosis (IM). Two methods were used to detect immune complexes: a C1q-binding assay (C1q-BA) and the Raji-cell radioimmunoassay (RIA). Patients were followed until there was complete serological recovery. Individual complement components were normal or elevated but three patients showed initial reduction in total haemolytic activity. IgG, IgM, and IgA rose moderately during the acute phase. All sera showed thymocyte-specific cytotoxic activity at some time during the acute phase but were negative by 6 months. The C1q-BA was positive initially in twelve patients but had returned to normal by 6 months. The standard Raji RIA was negative in fifty out of fifty-five samples tested and it is proposed that this reflects the predominant IgM antibody response in these patients. In contrast, incorporation of a multispecific anti-immunoglobulin into this assay yielded data that was frequently positive; these correlated highly with that of the C1q-BA (P<0·001). Lymphocytotoxic activity correlated with the C1q-BA (P<0·001) and the modified Raji RIA (P<0·05). Patterns of lymphocytotoxicity and immune complex reactivity suggested an inverse relationship between these two parameters. It is proposed that this lymphocytotoxicity leads to production of antibody of restricted class permitting enhanced clearance of immune complexes.