Skip to main content
Springer Nature Link
Log in

Alternations of surface antigens on leukocytes after severe injury: correlation with infectious complications

  • Original
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Objective: To investigate the alternations of surface antigens of leukocytes after severe injury and the correlation with clinical outcome.

Setting: Emergency Department and Intensive Care Unit of a university hospital.

Patients: Patients with severe trauma (injury severity score >16) were enrolled. Those who were transferred or had critical injuries were excluded.

Measurements and results: Polymorphonuclear cells (PMN) and mononuclear cells (MN) were isolated from patients on the 1st, 3rd and 7th day following injury. The mean fluorescent expressions of CD lib and CD16 of PMN, and CD25 of MN were measured and compared with those obtained from paralleled controls. Sixteen injured patients were included. The CD11b expressions of PMN increased on the 1st day and were still high on the 7th day. The CD16 expressions decreased on the 1st day and CD25 decreased on the 3rd day; both were still low on the 7th day. Six patients developed infectious complications. CDllb expression remained high and CD 16 expression remained low on three measurements of the infectious patients, whereas both expressions recovered on the last measurement of non-infectious patients. CD25 expression remained low in both groups. Three infectious patients with pneumonia died from mutiple organ failure.

Conclusion: Phenotypic alternations of leukocytes develop early after severe injury. The alternations may represent a state of activation of PMN and subsequent suppression of IL-2 related immunity. Persistent activation of PMN with enhanced CDllb and attenuated CD16 expression indicates the development of infectious complications and a poor prognosis can be anticipated if the infectious sites can not be controlled early.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Grogan JB, Miller RC (1973) Impaired function of polymorphonuclear leukocytes in patients with burns and other trauma. Surg Gynecol Obstet 137: 784–788

    PubMed  CAS  Google Scholar 

  2. Alexander JW, Ogle CK, Stinnett JD, MacMillan BG (1978) A sequential, prospective analysis of immunological abnormalities and infection following severe thermal injury. Ann Surg 188: 809–816

    Article  PubMed  CAS  Google Scholar 

  3. Maderazo EG, Albano SD, Wornick CL, Drezner AD, Quercia R (1983) Polymorphonuclear leukocyte migration abnormalities and their significance in severely traumatized patients. Ann Surg 198: 736–742

    Article  PubMed  CAS  Google Scholar 

  4. Arnaut MA (1990) Structure and function of the leukocyte adhesion molecules CD11/CD18. Blood 75: 1037–1050

    Google Scholar 

  5. Van de Winkel JGJ, Anderson CL (1991) Biology of human immunoglobulin G Fe receptors. J Leukoc Biol 49: 511–524

    PubMed  Google Scholar 

  6. Moore FD, Davis C, Rodrick M, Mannick JA, Fearon DT (1986) Neutrophil activation in thermal injury as assessed by increased expression of complement receptors. N Engl J Med 314: 948–953

    Article  PubMed  Google Scholar 

  7. Wood JJ, Rodrick ML, O’Mahony JB, Palder SB, Saporoschetz I, d’Eon P, Mannick JA (1984) Inadequate inter-leukin-2 production: a fundamental immunological deficiency in patients with major burns. Ann Surg 200: 311–320

    Article  PubMed  CAS  Google Scholar 

  8. Greenspan L, Mclellan BA, Greig H (1985) Abbreviated injury scale and injury severity score: A score chart. J Trauma 25: 60–64

    Article  PubMed  CAS  Google Scholar 

  9. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections, 1988. Am J Infect Control 16: 128–140

    Article  PubMed  CAS  Google Scholar 

  10. Ferrante A, Thong YH (1980) Optimal conditions for simultaneous purification of mononuclear and polymorphonuclear leukocytes from human blood by the hypaque-ficoll method. J Immunol Methods 36: 109–117

    Article  PubMed  CAS  Google Scholar 

  11. Ravetch J, Perussia B (1989) Alternation membrane forms of FcrR III (CD 16) on human NK cells and neutrophils. J Exp Med 170: 481–497

    Article  PubMed  CAS  Google Scholar 

  12. Huizinga TW, Haas M, Kleijer M, Nuijens JH, Root D, Von dem Borne AEGKr (1990) Soluble Fcr receptors III in human plasma originates from release by neutrophils. J Clin Invest 86: 416–423

    Article  PubMed  CAS  Google Scholar 

  13. Huizinga TW, Schoot CE, Jose C, Klaassen R, Kleijer M, Borne Albert EGK, Doos D, Tetteroo PAT (1988) The Pi-linked receptor FcrR III is released on stimulation of neutrophils. Nature 333: 667–669

    Article  PubMed  CAS  Google Scholar 

  14. Bich-Thuy LT, Samarut C, Brochier J, Revillard JP (1981) Suppression of the late stages of mitogen-induced human B-cell differentiation by Fcr receptors released from polymorphonuclear neutrophils. J Immunol 127: 1299–1303

    PubMed  CAS  Google Scholar 

  15. Daeron M, Fridman WH (1985) Fc receptors as regulatory molecules. Ann Inst Pasteur Immunol 136c: 383–437

    Google Scholar 

  16. Vindenes H, Bjerknes R (1994) Activation of polymorphonuclear neutrophilic granulocytes following burn injury: alternation of Fc-receptor and complement-receptor expression and of opsonophagocytosis. J Trauma 36: 161–167

    Article  PubMed  CAS  Google Scholar 

  17. Dana N, Todd RF III, Pitt J, Springer T, Arnaout MA (1984) Deficiency of a monocyte-granulocyte surface glycoprotein Mol in man. J Clin Invest 73: 153–159

    Article  PubMed  CAS  Google Scholar 

  18. Smith C, Marlin SD, Rothlein R, Toman C, Anderson D (1989) Cooperative interactions of LFA-1 and Mac-1 with intercellular adhesion molecule-1 in facilitating adherence and transendothelial migration of human neutrophils in vitro. J Clin Invest 83: 2008–2017

    Article  PubMed  CAS  Google Scholar 

  19. Bainton DF, Miller LJ, Kishimoto TK, Springer TA (1987) Leukocyte adhesion receptors are stored in peroxidase-negative granules of human neutrophils. J Exp Med 166:1641–1653

    Article  PubMed  CAS  Google Scholar 

  20. Diener AM, Beatty PG, Ochs HD, Harlan JM (1985) The role of neutrophil membrane glycoprotein 150 (GP 150) in neutrophil mediated endothelial cell injury in vitro. J Immunol 135: 537–543

    PubMed  CAS  Google Scholar 

  21. Simms HH, Amico RD (1991) Increased PMN CD lib/CD 18 expression following post-traumatic ARDS. J Surg Res 50: 362–367

    Article  PubMed  CAS  Google Scholar 

  22. Moore FA, Moore EE (1995) Evolving concepts in the pathogenesis of postinjury multiple organ failure. Surg Clin North Am 75: 257–277

    PubMed  CAS  Google Scholar 

  23. Akiyoshi T, Koba F, Arinaga S, Miyazaki S, Wada T, Tsuji H (1985) Impaired production of interleukin-2 after surgery. Clin Exp Immunol 59: 45–49

    PubMed  CAS  Google Scholar 

  24. Faist E, Schinkel C, Zimmer S, Kremer JP, von Donnersmarck GH, Schildberg FW (1993) Inadequate interleukin-2 synthesis and interleukin-2 messenger expression following thermal and mechanical trauma in humans is caused by defective transmembrane signaling. J Trauma 34: 846–854

    Article  PubMed  CAS  Google Scholar 

  25. Granelli-Piperno A (1988) In situ hybridization of IL-2 and 11-2 receptor mRNA in T cells activated in the presence or absence of cyclosporin A. J Exp Med 168: 1649–1658

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency, Division of Surgery, National Yang-Ming University and Veterans General Hospital-Taipei, Shih-Pai Road, 11217, Taipei, Taiwan, R.O.C.

    H. C. Shih, C. H. Su & C. H. Lee

Authors
  1. H. C. Shih
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. C. H. Su
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. C. H. Lee
    View author publications

    You can also search for this author inPubMed Google Scholar

Additional information

This study was supported by the National Science Council, R. O. C

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shih, H.C., Su, C.H. & Lee, C.H. Alternations of surface antigens on leukocytes after severe injury: correlation with infectious complications. Intensive Care Med 24, 152–156 (1998). https://doi.org/10.1007/s001340050537

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s001340050537

Key words