M Wick1, E Kollig, G Muhr, M Köller. 1. Department of Surgery, BG Kliniken Bergmannsheil-Universitätsklinik, Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany.
Abstract
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.
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: Javier Cabrera-Perez; Stephanie A Condotta; Vladimir P Badovinac; Thomas S Griffith Journal: J Leukoc Biol Date: 2014-05-02 Impact factor: 4.962
Authors: Rachael P Jackman; Garth H Utter; Marcus O Muench; John W Heitman; Matthew M Munz; Robert W Jackman; Hope H Biswas; Ryan M Rivers; Leslie H Tobler; Michael P Busch; Philip J Norris Journal: Transfusion Date: 2012-03-27 Impact factor: 3.157
Authors: P G Boelens; J C M Fonk; A P J Houdijk; R J Scheper; H J T H M Haarman; S Meijer; P A M Van Leeuwen; B M E von Blomberg-van der Flier Journal: Clin Exp Immunol Date: 2004-05 Impact factor: 4.330
Authors: Đorđe Miljković; Suzana Stanisavljević; Isaac J Jensen; Thomas S Griffith; Vladimir P Badovinac Journal: Immunol Lett Date: 2021-07-25 Impact factor: 4.230