[Immune paralysis of T-lymphocytes and monocytes in postoperative abdominal sepsis. Correlation of immune function with survival].
In vitro functions of stimulated peripheral T cells and monocytes were investigate in patients experiencing sepsis following major visceral surgery. Cell culture supernatants were analyzed by ELISA for IL-2, IFN-gamma, IL-4, IL-10, TNF-alpha, IL-1 beta, and IL-12p40. In addition, monocyte HLA class II expression was determined by flow cytometry. T cell secretion of IL-2, TNF-alpha, and in part IFN-gamma (but not IL-4) was significantly diminished in non-survivors throughout the entire course of sepsis, compared to controls and sepsis survivors. Production of IL-1 beta and IL-12 p40 by monocytes was strongly reduced in both survivors and non-survivors at the onset of sepsis. Persistence of depressed monocyte cytokine secretion correlated with lethality. Thus, overall suppression of cytokine production by T cells and monocytes was already observed at the beginning of postoperative sepsis. HLA class II expression by monocytes exhibited a strong and sustained down-regulation with no significant differences between sepsis survivors and non-survivors. In summary, suppression of both T cell and monocyte functions develops early during postoperative sepsis. Recovery of immune functions and severity of immune defects are associated with outcome.
Heidecke
C D
CD
Chirurgische Klinik und Poliklinik, Technischen Universität München.
Weighardt
H
H
Hensler
T
T
Bartels
H
H
Holzmann
B
B
D016207:Cytokines / Q000097:blood; D005434:Flow Cytometry; D005767:Gastrointestinal Diseases / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology; D009000:Monocytes / Q000276:immunology*; D013530:Surgical Wound Infection / Q000276:immunology* / Q000401:mortality; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology* / Q000401:mortality; D013601:T-Lymphocytes / Q000276:immunology*
D016207:Cytokines