Abstract
Host defense mechanisms are cell- mediated, humoral and phagocytic. Acquired derangements of one or many of the immune antibacterial defenses are common after injury. These defects include (a) a failure of T- cell response (DTH) to antigen stimulation manifested by negative skin test reactions to common antigens (anergy); (b) a failure of humoral response, or B- cell depression after appropriate antigen stimulation; and (c) development of serum inhibitors of phagocyte chemotaxis.
Anergy reflects an immunodeficiency state more profound than impaired T- cell function alone and, if left uncorrected, is associated with a markedly increased incidence of sepsis and associated mortality. Therapeutic implications of these findings for now and the future are summarized.
Résumé
Les défenses de l'organisme chez la traumatisé sont à la fois cellulaires, humorales et phagocytaires. Les altérations de l'une ou de plusieurs des défenses antibactériennes sont communes après tout traumatisme. Elles comprennent: 1) la défaillance de la réponse des cellules T à la stimulation antigénique qui se manifeste par une réaction cutanée négative aux antigènes courants (l'anergie); 2) la défaillance de la réponse humorale ou état défensif des cellules B, après stimulation antigénique appropriée; 3) le developpement des inhibiteurs sériques de la chemotaxis phagocytaire.
L'anergie réflète un état de déficience immunologique plus profond que l'altération isolée des cellules T. Quand elle n'est pas corrigée elle entraîne une élévation du taux de l'infection et de la mortalité. Les implications thérapeutiques liées à ces manifestations sont passées en revue aussi bien pour le temps présent que pour le futur.
Article PDF
Similar content being viewed by others
References
Rebuck, J.W., Crowley, J.H.: Method of studying leukocyte functions in vivo. Ann. N.Y. Acad. Sci.59:757, 1955
Kaplan, J.E., Saba, T.M.: Humoral deficiency and reticuloendothelial depression after traumatic shock. Am. J. Physiol.230:7, 1976
Saba, T.M.: Reticuloendothelial systemic host defense after surgery and traumatic shock. Cir. Shock2:91, 1975
Meakins, J.L.: Alterations of host defenses in surgical patients. In Surgical Infectious Diseases, R.L. Simmons and R.J. Howard, editors, New York, Appleton Century Crofts, 1982, pp. 278
Rode, H.N., Christou, N.V., Bubenia, O., et al.: Lymphocyte function in anergic patients. Clin. Exper. Immunol.47:155, 1982
Mazaheri, R., Rode, H.N., Abikar, K., Ing, A., Gordon, J.: Dysfunction of humoral immunity in anergic surgical patients. J. Clin. Immunol. (In press)
Christou, N.V., McLean, A.P.H., Meakins, J.L.: Host defense in blunt trauma: Interrelationships of kinetics of anergy and depressed neutrophil function, nutritional status, and sepsis. J. Trauma20:833, 1980
Superina, R.A., Christou, N.V., Meakins, J.L.: Failure of neutrophil delivery into skin windows in anergic surgical patients. Surg. Forum31:68, 1980
Miles, A.A., Miles, E.M., Buche, J.: The value and duration of defense reactions of the skin to the primary lodgement of bacteria. Br. J. Exp. Pathol.38:79, 1957
Shizgal, H.M., Milne, C., Spanier, A.H.: The effect of nitrogen-sparing intravenously administered fluids on postoperative body composition. Surgery85:496, 1979
Christou, N.V., Superina, R.A., Broadhead, M., Meakins, J.L.: Postoperative depression of host resistance: Determinants and effect of peripheral protein-sparing therapy. Surgery (In press)
Van Epps, D.E., Frierson, J.A., Williams, R.C.: Immunological studies of anergic patients. Infect. Immun.10:1003, 1974
Bohnen, J.M.A., Christou, N.V., DeVoe, I., Chiasson, L., Meakins, J.L.: Anergy secondary to intraperitoneal sepsis: An animal model. Surg. Forum (In press)
Author information
Authors and Affiliations
Additional information
Supported by a grant from the Medical Research Council of Canada.
Rights and permissions
About this article
Cite this article
MacLean, L.D. Systemic antibacterial mechanisms in trauma. World J. Surg. 7, 119–124 (1983). https://doi.org/10.1007/BF01655919
Issue Date:
DOI: https://doi.org/10.1007/BF01655919