title: Human leukocyte antigen-DR expression in peripheral blood mononuclear cells from healthy donors influenced by the sera of injured patients prone to severe sepsis.
abstract: 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.
authors.affiliation: Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Mueller
authors.affiliation: Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Kreuzfelder
authors.affiliation: Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
authors.forename: Baerbel
authors.initials: B
authors.lastname: Nyadu
authors.affiliation: Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Lindemann
authors.affiliation: Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Rebmannn
authors.affiliation: Department of Trauma Surgery, University Hospital Mannheim, Ruprecht-Karls University, Theodor-Kutzer-Ufer 1-3, 68167 , Mannheim, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Majetschak
authors.affiliation: Department of Trauma Surgery, University Hospital Mannheim, Ruprecht-Karls University, Theodor-Kutzer-Ufer 1-3, 68167 , Mannheim, Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Obertacke
authors.affiliation: Department of Trauma Surgery, University of Essen, Hufelandstr. 55, 45122 , Essen, Germany.
authors.forename: Ulrich F
authors.initials: UF
authors.lastname: Schade
authors.affiliation: Department of Trauma Surgery, University of Essen, Hufelandstr. 55, 45122 , Essen, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Nast-Kolb
authors.affiliation: Institute of Immunology, University of Essen, Virchowstrasse 171, 45122 , Essen, Germany. immunologie@uni-essen.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Grosse-Wilde
mesh_terms: 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
chemical_list: D006684:HLA-DR Antigens