T-cell response to staphylococcal enterotoxin B is reduced among heart failure patients on ventricular device support.
Infections are the major complication among patients on left ventricular device (LVAD) support. One mechanism that may explain the elevated incidence of infection is a deficiency in cellular immunity after LVAD placement. To test this hypothesis, we evaluated the in vitro T-cell-proliferative and cytokine response following challenge with staphylococcal enterotoxin B in 14 LVAD and 6 non-LVAD stable outpatients awaiting heart transplantation. Clinical outcome was followed for 12 months. Clinical outcome was poorer (P < .05) for LVAD vs non-LVAD patients. T-cell-proliferative response was lower (P = .002) for LVAD vs non-LVAD patients. Th1 cytokine expression was lower (P < .05) and Th2 cytokine expression was higher (P < .05) for LVAD vs non-LVAD patients. We conclude that LVAD recipients are hyporesponsive to superantigen challenge, indicating a depressed cellular immunity that may contribute to their increased susceptibility to infections.
Kimball
P
P
Department of Transplant Surgery, Medical College of Virginia Hospitals, Richmond, Virginia 23298, USA. pkimball@gems.vcu.edu
Flattery
M
M
Kasirajan
V
V
D004768:Enterotoxins / Q000494:pharmacology*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000276:immunology* / Q000601:surgery / Q000628:therapy*; D006353:Heart-Assist Devices; D008213:Lymphocyte Activation / Q000187:drug effects; D018089:Superantigens / Q000494:pharmacology; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D018417:Th1 Cells / Q000187:drug effects / Q000276:immunology; D018418:Th2 Cells / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome
D004768:Enterotoxins; D018089:Superantigens; C031818:enterotoxin B, staphylococcal