title: T-cell response to staphylococcal enterotoxin B is reduced among heart failure patients on ventricular device support.
abstract: 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.
authors.affiliation: Department of Transplant Surgery, Medical College of Virginia Hospitals, Richmond, Virginia 23298, USA. pkimball@gems.vcu.edu
authors.forename: P
authors.initials: P
authors.lastname: Kimball
authors.forename: M
authors.initials: M
authors.lastname: Flattery
authors.forename: V
authors.initials: V
authors.lastname: Kasirajan
mesh_terms: 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
chemical_list: D004768:Enterotoxins; D018089:Superantigens; C031818:enterotoxin B, staphylococcal