Changes in lymphocyte activity after thermal injury. The role of suppressor cells.
Changes in lymphocyte activity after thermal injury. The role of suppressor cells.
复制标题
热损伤后淋巴细胞活性的变化。
DOI：
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发表时间：
1979
影响因子：
15.9
通讯作者：
C. Baker
中科院分区：
文献类型：
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作者：
C. Miller;C. Baker
与严重热损伤相关的致命性败血症的高发病率被认为是由免疫能力丧失引起的。为了检测烧伤介导的免疫缺陷，研究了18例20-80%全层热烧伤患者外周血白细胞的淋巴细胞功能。我们检查了有丝分裂原反应的动力学，抑制活性的发展，以及单核细胞功能异常与脓毒症发病率的相关性。根据患者的临床病程分为三组。其中8例患者（III组）的Ficoll-Hypaque纯化白细胞在损伤后1-2天的植物血凝素反应正常，但在损伤后5-10天的植物血凝素反应明显下降（平均为正常的16%）。所有这些III组患者都经历了多次、严重、脓毒症发作，脓毒症死亡率为75%。其他10名烧伤个体表现出增强（II组）或不变（I组）的丝裂原反应性。在评估有丝分裂原反应的同时，通过持续的正常混合白细胞反应（MLR）来评估烧伤患者细胞的抑制活性。只有加入植物血凝素反应性低下的单核细胞（III组）才能显著降低MLR的增殖（平均减少80%），而之前的高反应，正常的MLR组合。加入损伤后立即收集的III组烧伤患者的细胞无抑制作用。加入I、II组患者细胞或正常个体细胞均无抑制作用。这些实验结果有力地表明，一种抑制性单核细胞至少是烧伤患者免疫能力下降的部分原因。
The high incidence of fatal septicemia associated with severe thermal injury is believed to result from a loss of immunocompetence. To detect burn-mediated immune defects, lymphocyte function in peripheral blood leukocytes from 18 individuals sustaining 20-80% full thickness thermal burns was investigated. We examined the kinetics of the mitogen responses, the development of suppressive activity, and the correlation of mononuclear cell functional abnormalities with the incidence of sepsis. Patients were divided into three groups corresponding to their clinical course. The phytohemagglutinin responses of Ficoll-Hypaque purified leukocytes from eight of these patients (group III) were normal at day 1-2 after injury, but were significantly depressed (mean 16% of normal) at days 5-10 after injury. All of these group III patients experienced multiple, severe, septic episodes, and septic mortality was 75%. The other 10 burned individuals showed either augmented (group II) or unaltered (group I) mitogen responsiveness. Concomitant with evaluation of their mitogen responses, the cells of burn patients were assessed for development of suppressive activity by addition to on-going normal mixed leukocyte reactions (MLR). Only the addition of mononuclear cells with depressed phytohemagglutinin responsiveness (group III) significantly decreased MLR proliferation (mean 80% reduction) by the previously highly responsive, normal MLR combinations. Addition of cells from group III burn patients collected immediately after injury had no suppressive effect. Addition of cells from patients in group I or II or of normal individual's cells had no suppressive effect. These experimental results strongly suggest that a suppressive mononuclear cell is at least partially responsible for the decreased immunocompetence of burn patients.