Organ B C, Antonacci A C, Chiao J, Chiao J, Kumar A, de Riesthal H F, Yuan L, Black D, Calvano S E
Department of Surgery, Cornell University Medical College, New York, New York 10021.
Ann Surg. 1989 Jul;210(1):78-89. doi: 10.1097/00000658-198907000-00012.
Thermal injury is associated with dysfunction of host defense systems. The present study used flow cytometric immunofluorescence analyses to investigate changes in number and phenotype of lymphocytes in seven different lymphoid compartments at 2, 6, 12, 24, 48, and 60 days after 50% total body-surface area thermal injury in the rat. Relative to sham-injured control rats, at postburn day 2, significant lymphopenia was observed in the peripheral blood along with depletion of lymphocytes from the spleen and thymus. By day 6 after injury, lymphocytes in the bone marrow and cervical lymph nodes decreased significantly while numbers in the spleen and thymus remained depressed. Splenic and cervical node lymphocyte numbers normalized by day 12, the bone marrow and thymus numbers still were significantly lower than control, and a 6.5-fold increase in number of lymphocytes was observed in the nodes draining the burn wound, pooled axillary, brachial, inguinal, and lumbar lymph nodes. At day 24 after injury, the thymus and bone marrow virtually were depleted of lymphocytes, the mesenteric lymph nodes manifested a significant decrease, and lymphocytes in the nodes draining the burn wound continued to increase in number. This same pattern was maintained on day 48, but numbers of lymphocytes in the mesenteric nodes normalized. At day 60 after injury, lymphocyte numbers in all tissues were normalized, but the spleen and nodes draining the burn wound where increased numbers compared to control persisted. Cell-surface phenotyping was performed on all lymphoid tissues at all time intervals to determine the percentages of lymphocytes comprising the following subsets: Ia+ cells (B cells and activated T cells), T cells, T-Helper/Inducer cells (T-H/I), and T-Suppressor/Cytotoxic (T-S/C) cells. Although changes in lymphocyte subset percentages were complex, they could be divided grossly into two phases. First, all compartments showed significant phenotypic changes in the first six days after burn. With the exception of the nodes draining the burn wound and the blood, this was followed by a return towards normal on day 12. The second phase then ensued with significant phenotypic changes again occurring in most tissues from days 24 to 60 after injury. These studies demonstrate that burn injury results in dramatic alterations in lymphocyte numbers and subset percentages in different lymphoid compartments. Immune alterations observed following thermal injury may be due, in part, to a redistribution of the cellular elements responsible for generation of the immune response.
热损伤与宿主防御系统功能障碍相关。本研究采用流式细胞术免疫荧光分析，调查大鼠50%体表面积热损伤后2、6、12、24、48和60天，七个不同淋巴区室中淋巴细胞数量和表型的变化。相对于假手术对照大鼠，烧伤后第2天，外周血出现明显淋巴细胞减少，同时脾脏和胸腺中的淋巴细胞耗竭。损伤后第6天，骨髓和颈部淋巴结中的淋巴细胞显著减少，而脾脏和胸腺中的淋巴细胞数量仍处于较低水平。脾脏和颈部淋巴结中的淋巴细胞数量在第12天恢复正常，骨髓和胸腺中的淋巴细胞数量仍显著低于对照组，且在烧伤创面引流淋巴结（汇集的腋窝、臂部、腹股沟和腰淋巴结）中观察到淋巴细胞数量增加了6.5倍。损伤后第24天，胸腺和骨髓中的淋巴细胞几乎耗竭，肠系膜淋巴结显著减少，烧伤创面引流淋巴结中的淋巴细胞数量持续增加。第48天维持了相同的模式，但肠系膜淋巴结中的淋巴细胞数量恢复正常。损伤后第60天，所有组织中的淋巴细胞数量均恢复正常，但脾脏和烧伤创面引流淋巴结中的淋巴细胞数量仍高于对照组。在所有时间间隔对所有淋巴组织进行细胞表面表型分析，以确定构成以下亚群的淋巴细胞百分比：Ia +细胞（B细胞和活化T细胞）、T细胞、辅助/诱导性T细胞（T-H/I）和抑制/细胞毒性T细胞（T-S/C）。虽然淋巴细胞亚群百分比的变化很复杂，但大致可分为两个阶段。首先，烧伤后的前六天，所有区室均出现显著的表型变化。除烧伤创面引流淋巴结和血液外，随后在第12天恢复正常。接着进入第二阶段，损伤后第24天至60天，大多数组织再次出现显著的表型变化。这些研究表明，烧伤会导致不同淋巴区室中淋巴细胞数量和亚群百分比发生显著改变。热损伤后观察到的免疫改变可能部分归因于负责产生免疫反应的细胞成分的重新分布。
