Document Detail


The potential pattern of circulating lymphocytes TH1/TH2 is not altered after multiple injuries.
MedLine Citation:
PMID:  11074886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: A shift in the balance of helper T cells type 1 (T(H)1) toward type 2 (T(H)2) has been suggested as a possible mechanism for impaired immune responses after severe trauma. We suggest that major injuries (polytrauma) induce an alteration in the pattern of T(H)1/T(H)2 cells. DESIGN, SETTING, AND PATIENTS: A prospective study of 35 polytraumatized patients (Injury Severity Score >16) admitted to a trauma intensive care unit at a level I trauma center (university hospital). INTERVENTIONS: Blood samples were collected from patients at various times during their stay in the intensive care unit and from age- and sex-matched healthy individuals. MAIN OUTCOME MEASURES: Serial determinations (n = 81) of intracellular interleukin (IL)-2 (T(H)1 cells) and IL-4 (T(H)2 cells) in stimulated CD3(+) T cells from patients with polytrauma twice a week during their stay in the intensive care unit accompanied by determination of the cell activation marker CD69 using 3-color flow cytometry. In parallel, the release of IL-2 and IL-4 from stimulated peripheral blood mononuclear cells and systemic plasma IL-4 levels were analyzed by conventional enzyme-linked immunosorbant assay. Healthy donors (n = 53) served as the control group. Data were related to outcome, Injury Severity Scores, and time after trauma. RESULTS: Expression of the cell activation marker CD69 was similar in stimulated lymphocytes from patients and healthy donors. There were no significant posttraumatic alterations in numbers of CD3(+) cells stained for intracellular IL-2 or IL-4, except for a minor decrease in IL-2(+) cells during the first week after trauma. Subgroups with high (>24) and lower (<25) Injury Severity Scores or survivors and nonsurvivors revealed no differences in intracellular cytokine staining. In contrast, patients revealed a highly significant decrease in the number of CD3(+) T cells. Mean systemic IL-4 levels did not differ in patients compared with healthy donors. Release of IL-2 and IL-4 from peripheral blood mononuclear cell fractions stimulated with phorbolmyristateacetate and ionomycin was significantly increased in patients with trauma but not from those stimulated with toxic shock syndrome toxin-1. CONCLUSIONS: Patients with multiple injuries have no significant alteration in the ratio of circulating T(H)1/T(H)2 cells. Thus, our results suggest pathomechanisms in posttraumatic T-cell suppression apart from alterations in the T(H)1/T(H)2 pattern.
Authors:
M Wick; E Kollig; G Muhr; M Köller
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  135     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-06     Completed Date:  2000-12-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1309-14     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, BG Kliniken Bergmannsheil-Universitätsklinik, Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany.
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MeSH Terms
Descriptor/Qualifier:
Antigens, CD / blood
Antigens, Differentiation, T-Lymphocyte / blood
Case-Control Studies
Enzyme-Linked Immunosorbent Assay
Female
Flow Cytometry
Humans
Interleukin-2 / blood
Interleukin-4 / blood
Lymphocyte Activation
Male
Middle Aged
Multiple Trauma / blood,  immunology*
Prospective Studies
Th1 Cells / immunology*
Th2 Cells / immunology*
Trauma Severity Indices
Chemical
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, Differentiation, T-Lymphocyte; 0/CD69 antigen; 0/Interleukin-2; 207137-56-2/Interleukin-4

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