Dysfunction of the mononuclear phagocytic system in sepsis.
An in vivo study has been undertaken of the Fc(IgG) receptor-mediated phagocytic capacity of macrophages (clearance of anti-rhesus D-coated-51 Cr-labelled autologous erythrocytes, expressed as half-lives) in 15 cases of sepsis to establish its behaviour and correlate this function to levels of circulating immune complexes (anti-Clq-nephelometry). Five patients with low activity (2261 +/- 859 minutes) developed septic shock; the other ten showed high activity (5.8 +/- 1.5 minutes) and did not develop septic shock. Differences from the control group (30 +/- 12 minutes) were found (p less than 0.001). Receptor activity was related to the presence of circulating immune complexes (p less than or equal to 0.001; delta = 0.862) but not to age, sex, or the presence/absence of splenomegaly during the illness. Eight patients responded favourably; seven patients died; but the receptor activity was not related to this. During sepsis it is possible to find higher Fc(IgG) receptor-mediated phagocytic capacity of macrophages. Excessive formation of circulating immune complexes has a negative influence on Fc(IgG) receptor-mediated phagocytosis. This activity of macrophages, measured at the start of the sepsis, was not associated with the final outcome of the patients' illness (cure or death).
Gutiérrez-Fernández
J
J
Division of Microbiology, Faculty of Medicine, University of Granada, Spain.
Maroto
M C
MC
Piédrola
G
G
Zamora
E
E
D000936:Antigen-Antibody Complex / Q000032:analysis; D000943:Antigens, Differentiation / Q000502:physiology; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008264:Macrophages / Q000502:physiology*; D008875:Middle Aged; D010587:Phagocytosis; D011961:Receptors, Fc / Q000502:physiology; D017452:Receptors, IgG; D018805:Sepsis / Q000503:physiopathology*
D000936:Antigen-Antibody Complex; D000943:Antigens, Differentiation; D011961:Receptors, Fc; D017452:Receptors, IgG