Human leukocyte antigen-DR expression in peripheral blood mononuclear cells from healthy donors influenced by the sera of injured patients prone to severe sepsis.
OBJECTIVE
To study the influence of sera from severely injured patients on the human leukocyte antigen (HLA)-DR expression of normal peripheral blood mononuclear cells (PBMC).


METHODS
In vitro study.


METHODS
University hospital.


METHODS
Sera from 34 patients were obtained within 8 h after trauma. Seventeen of these patients developed posttraumatic sepsis (sepsis group) and 17 recovered without infectious complications. Sera from ten healthy individuals served as controls. Phytohemagglutinin (PHA)-activated PBMC from 44 healthy donors were used to study the effects of a patient's serum.


RESULTS
Medium containing 5% of serum from the sepsis group significantly ( p<0.05) reduced the HLA-DR expression (channels, mean +/- standard error of the mean) on monocytes (patients 883+/-22, controls 962+/-15), B (patients 922+/-14, controls 972+/-7) and T cells (patients 932+/-13, controls 968+/-5) of PHA-activated PBMC. Significantly increased accumulation of TNFalpha on (1.8+/-0.4% of PBMC) and within T cells (0.98+/-0.26% of PBMC) was observed by flow cytometry after incubation with medium containing sera of the sepsis group compared with controls (on 0.5+/-0.1%, within 0.27+/-0.05% of PBMC). A significant negative correlation between relative cell counts of intracellular TNFalpha-positive T cells with HLA-DR expression was observed for monocytes ( r= -0.61), B cells ( r= -0.57) and proliferation ( r= -0.68) as estimated by (3)H-thymidine uptake [patients 139971+/-12844 counts per minute (cpm), controls 198973+/-19347 cpm, p<0.05] in the presence of sera from the sepsis group.


CONCLUSIONS
Reduced cellular immunity and, therefore, immunodeficiency after trauma appears to be caused by soluble factors influencing T cell function in particular.
Mueller
Anke
A
Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
Kreuzfelder
Ernst
E
Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
Nyadu
Baerbel
B
Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
Lindemann
Monika
M
Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
Rebmannn
Vera
V
Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
Majetschak
Matthias
M
Department of Trauma Surgery, University Hospital Mannheim, Ruprecht-Karls University, Theodor-Kutzer-Ufer 1-3, 68167 , Mannheim, Germany.
Obertacke
Udo
U
Department of Trauma Surgery, University Hospital Mannheim, Ruprecht-Karls University, Theodor-Kutzer-Ufer 1-3, 68167 , Mannheim, Germany.
Schade
Ulrich F
UF
Department of Trauma Surgery, University of Essen, Hufelandstr. 55, 45122 , Essen, Germany.
Nast-Kolb
Dieter
D
Department of Trauma Surgery, University of Essen, Hufelandstr. 55, 45122 , Essen, Germany.
Grosse-Wilde
Hans
H
Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany. immunologie@uni-essen.de.
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000097:blood* / Q000276:immunology; D006801:Humans; D015601:Injury Severity Score; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000097:blood* / Q000276:immunology; D014947:Wounds and Injuries / Q000097:blood* / Q000145:classification
D006684:HLA-DR Antigens