title: Reduced B cell HLA-DR expression and natural killer cell counts in patients prone to sepsis after injury.
abstract: OBJECTIVE
  To examine the influence of natural killer (NK) cells and HLA-DR molecules on B cells in the development of severe sepsis after injury.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Medical school, Germany.
  
  
  METHODS
  46 severely injured (Injury Severity Score >16) patients.
  
  
  METHODS
  Blood samples were taken immediately after admission and subsequently for 14 days.
  
  
  METHODS
  HLA-DR expression on B cells and counts of B and NK cells measured by flow cytometry, and morphological estimation of large granular lymphocytes by microscopy.
  
  
  RESULTS
  HLA-DR expression on circulating B cells was significantly reduced from days 6-14 after admission in 13 patients with subsequent severe sepsis compared with 33 patients who did not develop sepsis. In septic patients NK cell counts were significantly decreased from day 4 onwards (p < 0.05). CD16+/CD56+ cells correlated with the morphology of large granular lymphocytes.
  
  
  CONCLUSIONS
  In severely injured patients reduced counts of NK cells and HLA-DR molecules on B lymphocytes seem to be part of an immune deviation that is associated with the development of severe sepsis.
authors.affiliation: Institute of Immunology, University Hospital of Essen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ditschkowski
authors.forename: E
authors.initials: E
authors.lastname: Kreuzfelder
authors.forename: M
authors.initials: M
authors.lastname: Majetschak
authors.forename: U
authors.initials: U
authors.lastname: Obertacke
authors.forename: U F
authors.initials: UF
authors.lastname: Schade
authors.forename: H
authors.initials: H
authors.lastname: Grosse-Wilde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000209:etiology / Q000276:immunology*; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D006684:HLA-DR Antigens