title: Lymphocyte subset responses to trauma and sepsis.
abstract: One hundred five trauma patients admitted to three trauma centers with injury Severity Scores of 20 or greater had lymphocyte phenotypic subsets characterized throughout their hospital course. Total lymphocytes, pan-T (CD2), helper T (CD4), suppressor T (CD8), pan B (CD20), and DR expressing lymphocytes were quantitated by monoclonal antibodies and flow cytometric analysis. Results were analyzed between three patient groups: uninfected, uneventful recovery (n = 64); major infection (n = 26); and dead (n = 15; 7 with sepsis). A significant lymphopenia, maximal at 3 days, occurred in the first postinjury week compared with controls (p < 0.05), which recovered over the study period. A hierarchical distribution was found between the three outcome groups with the lowest numbers of several lymphocyte phenotypes in those who died. T helper and suppressor cells were similarly affected, but lowest in patients destined to develop infection or die. The helper-suppressor ratio, however, was similar in all three outcome groups. Therefore, modulation early after injury aimed at restoring these subsets may reduce the risk of subsequent infection.
authors.affiliation: Department of Surgery, University of Louisville, KY 40292.
authors.forename: W G
authors.initials: WG
authors.lastname: Cheadle
authors.forename: R M
authors.initials: RM
authors.lastname: Pemberton
authors.forename: D
authors.initials: D
authors.lastname: Robinson
authors.forename: D H
authors.initials: DH
authors.lastname: Livingston
authors.forename: J L
authors.initials: JL
authors.lastname: Rodriguez
authors.forename: H C
authors.initials: HC
authors.lastname: Polk
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000911:Antibodies, Monoclonal; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007239:Infections / Q000209:etiology* / Q000401:mortality; D015601:Injury Severity Score; D007958:Leukocyte Count; D016131:Lymphocyte Subsets; D008231:Lymphopenia / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000145:classification / Q000150:complications* / Q000401:mortality / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D013156:Splenectomy; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal