Impairment of specific host defense mechanisms in patients with chronic post-traumatic osteomyelitis.
We studied both in vivo and in vitro specific host defense mechanisms in patients suffering from chronic post-traumatic osteomyelitis (n = 26). The cell-mediated immunity in vivo was impaired as indicated by the reduced reactivity in the delayed type hypersensitivity skin test. The concanavalin A or phytohemagglutinin-induced T-cell proliferation in vitro was markedly decreased in comparison to healthy donors. In contrast, B-cell proliferation stimulated by Staphylococcus aureus Cowan I was not altered. While the absolute lymphocyte counts and the percentage of T, B, and O cells were within the normal range, nine out of the 26 patients showed a significantly diminished ratio of CD4+ and CD8+ T cells. Humoral immunity in the patients was less affected as assessed by the unchanged serum levels of immunoglobulins (Ig). However, the T-cell dependent polyclonal Ig synthesis after in vitro stimulation with pokeweed mitogen was suppressed. Our results provide evidence that cell-mediated immune functions are predominantly impaired in patients with post-traumatic osteomyelitis which may contribute to the persistence of the localized bone infection.
Schlüter
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Lehrstuhl für Med. Mikrobiologie und Immunologie, Ruhr-Universität Bochum, F.R.G.
Bergmann
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Josten
C
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Walz
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König
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W
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed; D007136:Immunoglobulins / Q000032:analysis; D007869:Leg Injuries / Q000150:complications*; D008213:Lymphocyte Activation; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology / Q000276:immunology*; D012882:Skin Tests
D007136:Immunoglobulins