The Effect of Prednisolone in Vitro on Immunoglobulin Production in Primary Biliary Cirrhosis

Immunoglobulin production and its regulation have been investigated in 36 untreated patients with primary biliary cirrhosis and 14 healthy controls. Using a haemolytic plaque assay, the number of cells spontaneously producing IgG or IgM was normal, while in contrast, proliferation of both IgG and IgM producing cells in the presence of pokeweed mitogen was impaired (P less than 0.01). There was in addition a defect of Con A induced suppression of proliferation of IgG and IgM producing cells (P less than 0.01), which was more marked in those with early disease than in those with advanced disease. In vitro incubation of mononuclear cells with prednisolone, 5 X 10(-8) M, corrected the defect of Con A induced suppression, but had no effect on spontaneous or pokeweed mitogen stimulated immunoglobulin production. Prednisolone was only effective if added prior to exposure to Con A. There is anecdotal evidence that corticosteroids may be beneficial in primary biliary cirrhosis and the results of the present study study suggest that further investigation of their role is warranted.