title: [Functions of circulating and intra-abdominal polymorphonuclear leukocytes during human secondary peritonitis].
abstract: BACKGROUND
  Aim of the study was to characterize different functions of circulating and emigrated, intra-abdominal polymorphonuclear leukocytes (cPMNs, ePMNs) during human secondary peritonitis.
  
  
  METHODS
  In patients (n=25) with diffuse secondary peritonitis circulating and emigrated PMNs were characterized intra- and until 96 h postoperatively. Patients were allocated to two different groups, e. g. patients with septic complications (shock, organ failure, n=11) and patients without complications (n=14) during peritonitis. In addition a control group of patients (n=10) with abdominal surgery but without peritonitis was investigated. The lucigenin- and luminol-enhanced chemiluminescence was used to determine extra- and intracellular oxygen radical generation of PMNs. Besides spontaneous oxygen radical generation of PMNs, stimulated radical production was investigated after the addition of ionophores A23 187 and C3-coated zymosan. Phagocytosis by PMNs was characterized with opsonized E. coli bacteria and fluorescence-activated cell analysis.
  
  
  RESULTS
  Especially patients with complicated peritonitis had strong and long-lasting changes of PMNs functions. The toxic and tissue-destroying production of extracellular oxygen radicals by circulating PMNs was enhanced (e. g., A23 187 - stimulated oxygen radical generation 433 +/- 89 cpm/cPMNs (peritonitis with complications) versus 90 +/- 30 cpm/cPMNs (peritonitis without complications) versus 110 +/- 44 cpm/cPMNs (controls), p < 0.05). Phagocytosis (58 +/- 9 % (ePMNs, peritonitis with complications) versus 81 +/- 6 % (ePMNs, peritonitis without complications) versus 82.2 +/- 1.6 % (ePMNs, controls), p < 0.05) and phagocytosis-associated intracellular oxygen radical generation (8.23 +/- 1.6 x 10(3) cpm/ePMNs (peritonitis with complications) versus 25.2 +/- 5.2 x 10(3) cpm/ePMNs (peritonitis without complications) versus 11.7 +/- 2.8 cpm x 10(3) cpm/ePMNs (controls) p < 0.05) were suppressed.
  
  
  CONCLUSIONS
  Not for all patients with peritonitis does it seem favourable to modulate PMNs-functions. If immunomodulation would be able to down-regulate exaggerated functions of circulating PMNs and to up-regulate the suppressed functions of emigrated PMNs patients with complicated peritonitis might benefit from this therapy.
authors.affiliation: Klinik für Allgemein- und Gefässchirurgie, Universitä tsklinik Frankfurt/Main.
authors.forename: K
authors.initials: K
authors.lastname: Holzer
authors.forename: A
authors.initials: A
authors.lastname: Richter
authors.forename: P
authors.initials: P
authors.lastname: Konietzny
authors.forename: F
authors.initials: F
authors.lastname: Schübel
authors.forename: K
authors.initials: K
authors.lastname: Wilhelm
authors.forename: D
authors.initials: D
authors.lastname: Henrich
mesh_terms: D003082:Colectomy; D005609:Free Radicals; D005743:Gastrectomy; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism; D008163:Luminescent Measurements; D009102:Multiple Organ Failure / Q000276:immunology; D009504:Neutrophils / Q000276:immunology*; D010537:Peritoneum / Q000276:immunology; D010538:Peritonitis / Q000276:immunology*; D011183:Postoperative Complications / Q000276:immunology*; D011379:Prognosis; D017382:Reactive Oxygen Species / Q000378:metabolism; D012772:Shock, Septic / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D005609:Free Radicals; D016209:Interleukin-8; D017382:Reactive Oxygen Species; D014409:Tumor Necrosis Factor-alpha
vernacular_title: Untersuchungen zu Funktionen zirkulierender und intraabdominaler polymorphkerniger Leukozyten bei Patienten mit sekundärer Peritonitis.