Deitch E A, Dobke M, Baxter C R
Arch Surg. 1985 Jan;120(1):78-84. doi: 10.1001/archsurg.1985.01390250070011.
Destruction of the skin barrier by thermal injury removes the major local defense barrier to bacteria. To determine whether a local defect in immunity also existed, the opsonic activity of blister fluid against Staphylococcus aureus and Pseudomonas aeruginosa as well as neutrophil chemotaxis were measured. The results of these studies indicated that blister fluid could not opsonize Pseudomonas. A series of repletion experiments indicated that the opsonic defect for Pseudomonas was not due to the presence of inhibitors but was due to the lack of normal serum factor(s). Although both the level of immunoglobulins and complement components in the blister fluid was depressed, the cause of the opsoninopathy appeared to be due to local consumption of complement in the burn wounds. In addition to the opsoninopathy, both neutrophil chemotaxis and random migration were also depressed. In conclusion, a burn injury appears to cause severe impairment of both cellular and humoral local immunity, which could predispose these patients to burn wound sepsis.
热损伤对皮肤屏障的破坏消除了对细菌的主要局部防御屏障。为了确定是否也存在局部免疫缺陷，测量了水疱液对金黄色葡萄球菌和铜绿假单胞菌的调理活性以及中性粒细胞趋化性。这些研究结果表明，水疱液不能调理铜绿假单胞菌。一系列补充实验表明，对铜绿假单胞菌的调理缺陷不是由于抑制剂的存在，而是由于缺乏正常血清因子。虽然水疱液中免疫球蛋白和补体成分的水平均降低，但调理素病的原因似乎是烧伤创面中补体的局部消耗。除了调理素病外，中性粒细胞趋化性和随机迁移也降低。总之，烧伤似乎会导致细胞和体液局部免疫的严重受损，这可能使这些患者易患烧伤创面脓毒症。
