[Humoral and cellular changes of non-specific immune response following severe trauma].
The influence of trauma and hemorrhagic shock on the non-specific immune system has been pointed out in various experimental studies. Other investigations have also been able to find a relationship between these changes and a higher incidence of post-traumatic complications in the form of organ failure. Our aim was to demonstrate the potential changes in the cellular defense system in a clinical study on multiple trauma patients. The polymorphonuclear leukocytes (PMNL) are the main representative of the mobile, non-specific immune system. Our study revealed a significant deterioration of PMNL function after trauma. The metabolic activity and phagocytic function were mainly affected by a decrease in the concentration of so-called "opsonins." The opsonins are important for the identification and engulfment of debris (necrosis, fat emboli and thrombi) and bacterial substances (endotoxin). Next to the opsonin level, a change in the receptor configuration is important for phagocytosis. However, we could not find any substantial evidence of surface receptor alteration. The reticuloendothelial cells (RES), a stationary phagocytic system, also showed a significant reduction in clearance function in these polytraumatized patients. Similar to PMNL, these disturbances were based on the reduction of the opsonine concentration. We were able to demonstrate a significant disturbance in immune function in multiple trauma patients with post-traumatic complications compared to patients with a normal clinical course after injury. Disturbances in the PMNL function (seen after 4 days) were found to appear after the RES disturbances. Systemic interaction between these two phagocytic systems cannot be excluded and further investigation is therefore required.
Regel
G
G
Dwenger
A
A
Gratz
K F
KF
Nerlich
M L
ML
Sturm
J A
JA
Tscherne
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007728:Kupffer Cells / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology*; D009895:Opsonin Proteins / Q000502:physiology*; D010587:Phagocytosis; D012128:Respiratory Distress Syndrome / Q000276:immunology*; D012772:Shock, Septic / Q000276:immunology
D009895:Opsonin Proteins
Humorale und zelluläre Veränderungen der unspezifischen Immunabwehr nach schwerem Trauma.