Polymorphonuclear leukocyte function in bacterial and viral infections.

Chemiluminescence (CL) production by polymorphonuclear leukocytes (PMNLs) was examined in 63 patients with bacterial infections and 63 healthy controls. The production was significantly higher in the patients (mean +/- standard error = 134.5 +/- 5.0 X 10(3) cpm) than in the controls (118.9 +/- 2.5 X 10(3) cpm; p less than 0.05). In 38 patients CL values were within the normal range and in 19 patients above. CL production below that of any control occurred in 6 patients: 3 (of 4) with staphylococcal endocarditis, 2 (of 4) with pneumococcal meningitis and 1 with salmonella septicaemia and osteomyelitis. PMNL hexose monophosphate shunt activity as measured by glucose metabolism correlated with CL production. Patients with low CL production more often had large numbers of juvenile and immature myeloid cells in the peripheral blood than patients with normal or high CL values. 3/6 patients with low CL values died, 2/38 with normal and 0/19 with high values. Directed and spontaneous PMNL migration was examined in 39 of the 63 patients with bacterial infections. 13 patients had PMNLs with higher directed and 16 with higher spontaneous migration capacity than their corresponding controls. The remaining patients had PMNLs with lower migration capacity. 2 of the 39 patients died. Each had PMNLs with low migration capacity. CL production by PMNLs was examined in 16 patients with viral infections and 16 healthy controls. The production was significantly lower in the patients (mean +/- standard error = 105.5 +/- 6.6 X 10(3) cpm) than in the controls (129.1 +/- 5.3 X 10(3) cpm; p less than 0.01). 15 patients had lower values than their corresponding controls. The PMNL migration capacity was also lower in the patients. These findings indicate that the majority of patients with bacterial infections have PMNLs with normal or increased function. However, some patients have reduced PMNL function and this reduction may contribute to a fatal outcome of the disease. Patients with viral infections usually have reduced PMNL function.