Moore F D, Davis C, Rodrick M, Mannick J A, Fearon D T
N Engl J Med. 1986 Apr 10;314(15):948-53. doi: 10.1056/NEJM198604103141503.
We studied neutrophil activation in patients with burns by serial immunofluorescent measurement of neutrophil expression of the complement opsonin receptors CR1 and CR3. CR1-dependent fluorescence was initially (days 0 through 5 after the burn) elevated (mean +/- SEM, 294 +/- 42 vs. 63 +/- 6 in the controls; P less than 0.001) and gradually returned to normal (days 6 through 8, 270 +/- 62, P less than 0.001; days 9 through 13, 185 +/- 38, P less than 0.001; days 14 through 19, 143 +/- 27, P less than 0.001; and days 20 through 50, 93 +/- 5, P less than 0.04). CR3-dependent fluorescence paralleled that of CR1. Neutrophil chemotaxis in response to zymosan-activated serum, a source of C5a, was depressed (days 0 through 5, 77 +/- 4 percent of control, P less than 0.001; days 6 through 8, 70 +/- 4 percent, P less than 0.001; days 9 through 13, 74 +/- 3 percent, P less than 0.001; days 14 through 19, 90 +/- 4 percent, P less than 0.01; and days 20 through 50, 97 +/- 3 percent, P not significant) and inversely correlated with CR1- and CR3-dependent fluorescence (r = -0.559, P less than 0.001; and r = -0.709, P less than 0.001, respectively). Plasma C3a desArg levels were above normal (100 +/- 5 ng per milliliter) throughout (days 0 through 5, 305 +/- 42; days 6 through 8, 546 +/- 69; days 9 through 13, 490 +/- 72; days 14 through 19, 409 +/- 54; and days 20 through 50, 260 +/- 36; all P less than 0.005). Thus, neutrophils in burned patients were activated as indicated by increased expression of complement receptors. The correlation between this increase and the depression of chemotaxis in response to zymosan-activated serum suggests that C5a is responsible for systemic neutrophil activation, which may contribute to the increased susceptibility to infection of patients with burns.
我们通过对中性粒细胞补体调理素受体CR1和CR3表达进行系列免疫荧光测量，研究了烧伤患者中性粒细胞的激活情况。依赖CR1的荧光最初（烧伤后0至5天）升高（平均值±标准误，294±42，而对照组为63±6；P<0.001），并逐渐恢复正常（6至8天，270±62，P<0.001；9至13天，185±38，P<0.001；14至19天，143±27，P<0.001；20至50天，93±5，P<0.04）。依赖CR3的荧光与CR1的荧光变化趋势平行。对酵母聚糖激活血清（一种C5a来源）的中性粒细胞趋化性受到抑制（0至5天，为对照组的77±4%，P<0.001；6至8天，70±4%，P<0.001；9至13天，74±3%，P<0.001；14至19天，90±4%，P<0.01；20至50天，97±3%，P无显著性差异），且与依赖CR1和CR3的荧光呈负相关（r=-0.559，P<0.001；r=-0.709，P<0.001）。血浆C3a去精氨酸水平在整个过程中均高于正常（100±5 ng/ml）（0至5天，305±42；6至8天，546±69；9至13天，490±72；14至19天，409±54；20至50天，260±36；所有P<0.005）。因此，如补体受体表达增加所示，烧伤患者的中性粒细胞被激活。这种增加与对酵母聚糖激活血清趋化性抑制之间的相关性表明，C5a是全身性中性粒细胞激活的原因，这可能导致烧伤患者感染易感性增加。
