Red blood cell T-activation and hemolysis in surgical intensive care patients with severe infections.
The exposure of Thomsen-Friedenreich (T) antigens on RBCs, serum neuraminidase, and serum hemoglobin levels were investigated in 53 adult surgical intensive care unit (ICU) patients with septicemia. Unmasked T-antigens were assayed by a hemagglutination test using peanut agglutinin (PNA) (direct anti-T test), and by an indirect anti-T test employing rabbit anti-PNA globulin. RBC T-activation was demonstrated in 17/53 patients (32%); in 2/53 patients (4%) the direct anti-T test was positive, indicating strong T-exposure. No polyagglutination phenomena were observed. Serum neuraminidase was elevated in 12/17 (71%) patients with T-activation and in 7/36 (19%) patients without T-activation. Free serum hemoglobin was elevated in 12/17 (71%) patients with T-activation and in 5/36 (14%) patients without T-activation. Correlations between T-activation and serum neuraminidase and between T-activation and serum hemoglobin were significant (p less than 0.001). Potentially neuraminidase-releasing bacteria were demonstrated in 13/17 (76%) patients with RBC T-exposure. We conclude that neuraminidase-induced RBC T-activation and subsequent hemolysis may be involved in the pathomechanism of hemolytic anemia in patients with severe infections.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate; D003422:Critical Care; D004187:Disaccharides / Q000276:immunology*; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007239:Infections / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009439:Neuraminidase / Q000097:blood / Q000494:pharmacology; D011183:Postoperative Complications / Q000276:immunology*
D015295:Antigens, Tumor-Associated, Carbohydrate; D004187:Disaccharides; D006454:Hemoglobins; C016467:Thomsen-Friedenreich antigen; D009439:Neuraminidase