Hansbrough J F, Gadd M A
Department of Surgery, University of California, San Diego Medical Center 92103.
Surgery. 1989 Jul;106(1):69-80.
The immune suppression that frequently accompanies severe injury undoubtedly contributes to subsequent infectious complications. Various lymphocyte subpopulations may be identified by surface antigen expression, and alterations in antigen expression by lymphocytes may reflect host immune competence. Using monoclonal antibodies (Moabs) and dual-color flow cytometry, we studied lymphocyte phenotypic expression in mice after either controlled burn injury or hind-limb amputation, with use of peripheral blood, lymph node, and spleen for cell preparation. Moabs were utilized specific for T cells (Lyt-1), helper/inducer cells (L3T4), suppressor/cytotoxic cells (Lyt-2), B cells (IgG), and activated T cells (Ia or IL-2 receptor). The assay techniques called for small amounts of tissue and avoided gradient procedures that might result in selective loss of some lymphocyte populations. The most consistent changes observed were depressions in percentages of L3T4+ and Lyt-2+ cells in spleens of burned mice, accompanied by depression in Ia+ (possibly activated or proliferating) subsets of L3T4+ and Lyt-2+ cells, and the appearance of increased percentages of non-B, non-T lymphocytes. Changes in lymph node cells were minimal. The major alteration seen in peripheral blood was substantial depression of Ia+ subsets, although burned mice had increased circulating Lyt-2+ cells on several late postburn days. Burned mice, unlike limb-trauma mice, had marked splenic hypertrophy with more than a 300% increase in spleen weight after the 30-day postburn period. Eschar excision/implantation experiments indicated that splenic hypertrophy and splenocyte phenotypic changes are related to the presence of burned tissue, which suggests that burned tissue may partially mediate immune changes that accompany severe burn injury.
严重创伤常伴随的免疫抑制无疑会导致随后的感染并发症。各种淋巴细胞亚群可通过表面抗原表达来识别,淋巴细胞抗原表达的改变可能反映宿主的免疫能力。我们使用单克隆抗体(Moabs)和双色流式细胞术,以外周血、淋巴结和脾脏制备细胞,研究了小鼠在控制性烧伤或后肢截肢后的淋巴细胞表型表达。使用了对T细胞(Lyt-1)、辅助/诱导细胞(L3T4)、抑制/细胞毒性细胞(Lyt-2)、B细胞(IgG)和活化T细胞(Ia或IL-2受体)特异的Moabs。该检测技术所需组织量少,避免了可能导致某些淋巴细胞亚群选择性丢失的梯度操作。观察到的最一致变化是烧伤小鼠脾脏中L3T4+和Lyt-2+细胞百分比降低,同时L3T4+和Lyt-2+细胞的Ia+(可能活化或增殖)亚群降低,以及非B、非T淋巴细胞百分比增加。淋巴结细胞的变化最小。外周血中观察到的主要变化是Ia+亚群显著降低,尽管烧伤小鼠在烧伤后期的几个日子里循环Lyt-2+细胞增加。与肢体创伤小鼠不同,烧伤小鼠有明显的脾肿大,烧伤后30天脾脏重量增加超过300%。焦痂切除/植入实验表明,脾肿大和脾细胞表型变化与烧伤组织的存在有关,这表明烧伤组织可能部分介导了严重烧伤损伤伴随的免疫变化。