Hiki N, Berger D, Buttenschoen K, Boelke E, Seidelmann M, Strecker W, Kinzl L, Beger H G
Department of General Surgery, University of Ulm, Germany.
J Trauma. 1995 May;38(5):794-801. doi: 10.1097/00005373-199505000-00020.
The aim of this study was to establish the incidence of endotoxemia and the influence of endotoxin on specific antibody response after multiple injury. Blood samples were collected from 39 patients (median Injury Severity Score: 20.5) at 0-3 and 6-12 hours, and 1, 3, 5, and 10 days after admission. The endotoxin plasma levels were high at the first time point (mean = 0.421 endotoxin units/mL) and decreased in the later course. Total immunoglobulin levels of IgM, IgG, or IgA were low and increased throughout the observation period. Specific antibodies of the IgM class against two lipid A and four lipopolysaccharide preparations increased transiently but significantly on day 3 and/or day 5. No changes of specific antibody content against endotoxin or lipid A was seen in the IgG or IgA class. The specific antibody content of the different classes against alpha-hemolysin of Staphylococcus aureus did not differ during 10 days after trauma. The specific antibodies of the IgM class reacted with all lipid A and LPS lipopolysaccharide preparations demonstrating cross-reactivity. These results suggest that endotoxin may be a specific stimulator of IgM antiendotoxin antibody secretion following trauma.
本研究的目的是确定内毒素血症的发生率以及内毒素对多发伤后特异性抗体反应的影响。在入院后0 - 3小时、6 - 12小时、1天、3天、5天和10天，从39例患者（损伤严重度评分中位数：20.5）采集血样。内毒素血浆水平在第一个时间点较高（平均 = 0.421内毒素单位/mL），在后续过程中下降。IgM、IgG或IgA的总免疫球蛋白水平较低，并在整个观察期内升高。针对两种脂多糖A和四种脂多糖制剂的IgM类特异性抗体在第3天和/或第5天短暂但显著增加。IgG或IgA类中针对内毒素或脂多糖A的特异性抗体含量未见变化。创伤后10天内，针对金黄色葡萄球菌α - 溶血素的不同类别的特异性抗体含量无差异。IgM类特异性抗体与所有脂多糖A和脂多糖制剂反应，显示出交叉反应性。这些结果表明，内毒素可能是创伤后IgM抗内毒素抗体分泌的特异性刺激物。
