Bjerknes R, Vindenes H, Laerum O D
Department of Pathology, Gade Institute, University of Bergen, Haukeland Hospital, Norway.
Blood Cells. 1990;16(1):127-41; discussion 142-3.
Neutrophil functions were examined longitudinally in 16 patients with large burns using multiparameter flow cytometry (FCM). At admission and through the first 10 days, the neutrophil expression of surface complement receptors for C3b (CR1) and C3bi (CR3) was increased, whereas neutrophil Fc receptor III (FcRIII) expression decreased. The phagocytosis of C3-opsonized Candida albicans increased during the same time period, whereas the ingestion of Ig-opsonized C. albicans decreased. The neutrophil intracellular killing of C. albicans was reduced by about 25% at admission. The microbicidal capacity was further compromised during the next 2 weeks, with a 50% reduction of intracellular killing 10 days following injury. The kinetics of neutrophil phagolysosomal acidification was altered during the first 20 days after burn injury, as the initial alkalinization of the phagolysosomes documented in control neutrophils could not be demonstrated in patients cells. In addition, patient neutrophil H2O2-production, which was only slightly reduced at admission, was gradually decreased during the first 2 weeks, with an oxidative burst about 40% lower than controls at day 10. All neutrophil functions tested were normal at discharge. The results demonstrate significant metabolic and functional alterations in neutrophils from patients with large burns. The data are consistent with a general activation of circulating neutrophils in the early phase after thermal injury, which is followed by impairment of neutrophil microbicidal mechanisms that may predispose for infectious complications.
采用多参数流式细胞术（FCM）对16例大面积烧伤患者的中性粒细胞功能进行了纵向研究。入院时及伤后前10天，中性粒细胞表面C3b补体受体（CR1）和C3bi补体受体（CR3）的表达增加，而中性粒细胞Fc受体III（FcRIII）的表达降低。同期，C3调理的白色念珠菌的吞噬作用增加，而Ig调理的白色念珠菌的摄取减少。入院时中性粒细胞对白色念珠菌的胞内杀伤作用降低约25%。在接下来的2周内，杀菌能力进一步受损，伤后10天胞内杀伤作用降低50%。烧伤后最初20天内，中性粒细胞吞噬溶酶体酸化的动力学发生改变，因为在对照中性粒细胞中记录到的吞噬溶酶体最初的碱化现象在患者细胞中未得到证实。此外，患者中性粒细胞H2O2的产生在入院时仅略有降低，在伤后前2周逐渐下降，伤后10天时氧化爆发比对照组低约40%。所有检测的中性粒细胞功能在出院时均正常。结果表明，大面积烧伤患者的中性粒细胞存在明显的代谢和功能改变。这些数据与热损伤后早期循环中性粒细胞的普遍激活一致，随后中性粒细胞杀菌机制受损，这可能易导致感染性并发症。
