Bjornson A B, Altemeier W A, Bjornson H S
Ann Surg. 1980 Mar;191(3):323-9. doi: 10.1097/00000658-198003000-00011.
Studies were performed to evaluate complement, opsonins, and the immune response to bacterial infection in burned patients. Concentrations and functional acitivities of components of the classical and alternative complement pathways were measured in the sera of four septic, two bacteremic, and four nonseptic burned patients. In addition, heat-labile and heat-stable opsonic activity and agglutinin titers directed against the infecting bacterial strains were measured in the sera of the four septic patients and in an additional group of 11 septic burned patients with abnormal complement profiles. Functional activity of the alternative complement pathway and the concentration of properdin were shown to be persistently decreased during eight weeks postburn in the septic, bacteremic, and nonseptic burned patients; reduced classical pathway activity was demonstrated during the initial postburn period only in the septic patients. Two of the 15 septic patients had decreased heat-labile serum opsonic activity for their infecting bacterial strains, which occurred only during the initial postburn period. Heat-stable opsonins and agglutinin titers in the patients' sera directed against the infecting bacterial strains were equivalent to those in normal human sera, except for the agglutinin titers to Streptococcus faecalis which were increased in the patients' sera in comparison to the normal sera. These results indicate that the multiple complement abnormalities which occur in septic burned patients do not predispose these patients to bacterial infection by decreasing serum opsonic activity. Moreover, heat-stable immune IgG antibodies are not produced during septicemia which facilitate opsonization of the infecting bacterial strains in the absence of an intact complement system.
开展了多项研究，以评估烧伤患者的补体、调理素以及对细菌感染的免疫反应。对4例脓毒症烧伤患者、2例菌血症烧伤患者和4例非脓毒症烧伤患者的血清进行了经典补体途径和替代补体途径成分的浓度及功能活性检测。此外，还对4例脓毒症患者以及另外11例补体谱异常的脓毒症烧伤患者的血清进行了针对感染菌株的热不稳定和热稳定调理活性及凝集素滴度检测。结果显示，脓毒症、菌血症和非脓毒症烧伤患者在烧伤后8周内，替代补体途径的功能活性和备解素浓度持续下降；仅在脓毒症患者中，烧伤后初期出现经典途径活性降低。15例脓毒症患者中有2例针对其感染菌株的热不稳定血清调理活性降低，且仅发生在烧伤后初期。患者血清中针对感染菌株的热稳定调理素和凝集素滴度与正常人血清相当，但针对粪肠球菌的凝集素滴度相比正常人血清有所升高。这些结果表明，脓毒症烧伤患者出现的多种补体异常并不会通过降低血清调理活性而使这些患者易发生细菌感染。此外，脓毒症期间不会产生热稳定免疫IgG抗体，而在缺乏完整补体系统的情况下，热稳定免疫IgG抗体有助于感染菌株的调理作用。
