Changes of spleen dendritic cells in the terminal stage of multiple organ dysfunction syndrome.

Immune dysfunction is associated with the onset of multiple organ dysfunction syndrome (MODS). To study the immune damage in the spleen, we observed pathological features of the spleen and investigated the number of splenic dendritic cells and T lymphocytes in MODS patients, 9 human MODS cases and 25 normal spleens were examined by light microscope, electron microscope and immunohistochemistry (S-100, CD11c, CD205, CD1a, CD80 and HLA-DR). There was resolution and dispersion of splenic corpuscles, especially white corpuscles, accompanied by apoptosis of a large amount of lymphocytes and increased number of splenic dendritic cells (DCs). CD1a+/S-100+ DCs and CD205 /S-100 DCs increased but the CD80+/CD11c+ DCs and CD1a+/HLA-DR DCs decreased in MODS patients(p < 0.01), CD80+/CD11c+ DCs and CD1a/HLA-DR-DCs were mainly surrounding the remote periarterial lymphoid sheath and in red pulp. The ratio of CD4+/CD8+ T lymphocyte declined markedly. The results indicated that at the terminal stage of MODS, the spleen was seriously damaged, the splenic DCs were inactivated and many lymphocytes were lost, especially CD4+ T, which induced T cells incapacitation and immune suppression. It is suggested that there is an important relation between changes of splenic dendritic cells and loss of lymphocyts and pathogenesis of MODS.