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. 1978 Aug;188(2):209–215. doi: 10.1097/00000658-197808000-00014

Association of sepsis with an immunosuppressive polypeptide in the serum of burn patients.

M B Constantian
PMCID: PMC1396754  PMID: 686889

Abstract

One hundred ninety serum samples from 51 burned patients were tested for immunosuppressive activity which might explain decreased host immune competence following thermal injury. The serum from a variable but significant percentage of these patients suppressed the response of normal human peripheral blood lymphocytes to phytohemagglutinin. The occurrence of immunosuppressive activity paralleled the severity of the injury. Ten of ten severely burned patients (severity index greater than 40), but only 20 of 30 patients with index 10--39.9, and three of 11 patients with Index 0--9.9 developed suppressive serum. Differences between these groups were significant (p less than .05). In all 19 patients who became septic, immunosuppressive serum activity immediately preceded or coincided with the septic episode. In contrast to the effect on lymphocytes, burn sera stimulated fibroblast proliferation. Immunosuppressive activity did not correlate with serum cortisol levels, blood transfusion, protein-calorie malnutrition, or anesthesia. Suppressive sera were not cytotoxic. A majority of the active serum factor(s) was contained in a low molecular weight (less than 10,000 daltons) polypeptide subfraction.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alexander J. W. Effect of thermal injury upon the early resistance to infection. J Surg Res. 1968 Mar;8(3):128–137. doi: 10.1016/0022-4804(68)90074-7. [DOI] [PubMed] [Google Scholar]
  2. Allgöwer M., Cueni L. B., Städtler K., Schoenenberger G. A. Burn toxin in mouse skin. J Trauma. 1973 Feb;13(2):95–111. doi: 10.1097/00005373-197302000-00002. [DOI] [PubMed] [Google Scholar]
  3. Burger D. R., Lilley D. P., Vetto R. M. Lymphocyte suppression associated with alpha globulin. Changes in cellular immunity. Cell Immunol. 1974 Mar 15;10(3):432–441. doi: 10.1016/0008-8749(74)90134-8. [DOI] [PubMed] [Google Scholar]
  4. Constantian M. B., Menzoian J. O., Fisher J. C., Nimberg R. B., Schmid K., Mannick J. A. A method of assessing impairment of immunity after trauma. Surg Forum. 1975;26:1–3. [PubMed] [Google Scholar]
  5. Constantian M. B., Menzoian J. O., Nimberg R. B., Schmid K., Mannick J. A. Association of a circulating immunosuppressive polypeptide with operative and accidental trauma. Ann Surg. 1977 Jan;185(1):73–79. doi: 10.1097/00000658-197701000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cooperband S. R., Badger A. M., Davis R. C., Schmid K., Mannick J. A. The effect of immunoregulatory globulin (IRA) upon lymphocytes in vitro. J Immunol. 1972 Jul;109(1):154–163. [PubMed] [Google Scholar]
  7. Daniels J. C., Larson D. L., Abston S., Ritzmann S. E. Serum protein profiles in thermal burns. I. Serum electrophoretic patterns, immunoglobulins, and transport proteins. J Trauma. 1974 Feb;14(2):137–152. [PubMed] [Google Scholar]
  8. Espanol T., Todd G. B., Soothill J. F. The effect of anaesthesia on the lymphocyte response to phytohaemagglutinin. Clin Exp Immunol. 1974 Sep;18(1):73–79. [PMC free article] [PubMed] [Google Scholar]
  9. Fernandez L. A., MacSween J. M., Langley G. R. Lymphocyte responses to phytohaemagglutinin: age-related effects. Immunology. 1976 Oct;31(4):583–587. [PMC free article] [PubMed] [Google Scholar]
  10. Garcia-Giralt E., Morales V. H., Bizzini B., Lasalvia E. Prevention of graft versus host reaction by incubation of lymphoid cells with a splenic extract (not affecting the repopulation of the haemopoietic tissue). Cell Tissue Kinet. 1973 Nov;6(6):567–571. doi: 10.1111/j.1365-2184.1973.tb01647.x. [DOI] [PubMed] [Google Scholar]
  11. Glaser M., Nelken D., Ofek I., Bergner-Rabinowitz S., Ginsburg I. Alpha globulin decreases resistance of mice to infection with group A Streptococcus. J Infect Dis. 1973 Mar;127(3):303–306. doi: 10.1093/infdis/127.3.303. [DOI] [PubMed] [Google Scholar]
  12. Goodman J. S., Schaffner W., Collins H. A., Battersby E. J., Koenig M. G. Infection after cardiovascular surgery. Clinical study including examination of antimicrobial prophylaxis. N Engl J Med. 1968 Jan 18;278(3):117–123. doi: 10.1056/NEJM196801182780301. [DOI] [PubMed] [Google Scholar]
  13. Green S. S., Wistar R., Jr, Sell K. W. Mitogen-stimulated lymphocyte inhibition by supernatants of crowded lymphocytoblasts. Transplantation. 1974 Dec;18(6):496–502. doi: 10.1097/00007890-197412000-00004. [DOI] [PubMed] [Google Scholar]
  14. Hanna N., Kalderon R., Nelken D. Inhibition of T- and B-lymphocyte functions by normal immunosuppressive protein. Immunology. 1975 Sep;29(3):433–443. [PMC free article] [PubMed] [Google Scholar]
  15. KAY G. D. Prolonged survival of a skin homograft in a patient with very extensive burns. Ann N Y Acad Sci. 1957 Mar 22;64(5):767–774. doi: 10.1111/j.1749-6632.1957.tb52471.x. [DOI] [PubMed] [Google Scholar]
  16. LEWIS M. R., COLE W. H. Experimental increase of lung metastases after operative trauma (amputation of limb with tumor). AMA Arch Surg. 1958 Oct;77(4):621–626. doi: 10.1001/archsurg.1958.04370010153015. [DOI] [PubMed] [Google Scholar]
  17. MacLean L. D., Meakins J. L., Taguchi K., Duignan J. P., Dhillon K. S., Gordon J. Host resistance in sepsis and trauma. Ann Surg. 1975 Sep;182(3):207–217. doi: 10.1097/00000658-197509000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Mani M. M., Volenec F. J., Humphrey L. J., Robinson D. W. Lymphocyte subpopulation alterations in thermal injury and acute infection. Surg Forum. 1976;27(62):560–563. [PubMed] [Google Scholar]
  19. Mannick J. A., Schmid K. Prolongation of allograft survival by an alpha globulin isolated from normal blood. Transplantation. 1967 Jul;5(4 Suppl):1231–1238. doi: 10.1097/00007890-196707001-00063. [DOI] [PubMed] [Google Scholar]
  20. McMaster R., Levy J. G. Immunosuppression of normal lymphoid cells by serum from mice undergoing chronic graft-vs-host disease. J Immunol. 1975 Nov;115(5):1400–1403. [PubMed] [Google Scholar]
  21. Minton J. P., Bianco M. A. Serum alpha2-globulins in breast carcinoma. Arch Surg. 1974 Aug;109(2):238–240. doi: 10.1001/archsurg.1974.01360020100019. [DOI] [PubMed] [Google Scholar]
  22. Munster A. M., Eurenius K., Katz R. M., Canales L., Foley F. D., Mortensen R. F. Cell-mediated immunity after thermal injury. Ann Surg. 1973 Feb;177(2):139–143. doi: 10.1097/00000658-197302000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Murphy B. E. Some studies of the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol Metab. 1967 Jul;27(7):973–990. doi: 10.1210/jcem-27-7-973. [DOI] [PubMed] [Google Scholar]
  24. Nelson D. S. Production by stimulated macrophages of factors depressing lymphocyte transformation. Nature. 1973 Nov 30;246(5431):306–307. doi: 10.1038/246306a0. [DOI] [PubMed] [Google Scholar]
  25. Nimberg R. B., Glasgow A. H., Menzoian J. O., Constantian M. B., Cooperband S. R., Mannick J. A., Schmid K. Isolation of an immunosuppressive peptide fraction from the serum of cancer patients. Cancer Res. 1975 Jun;35(6):1489–1494. [PubMed] [Google Scholar]
  26. Occhino J. C., Glasgow A. H., Cooperband S. R., Mannick J. A., Schmid K. Isolation of an immunosuppressive peptide fraction from human plasma. J Immunol. 1973 Mar;110(3):685–694. [PubMed] [Google Scholar]
  27. Osteen R. T., Wilson R. E. Immunocompetence measured by antibody--dependent cell--mediated cytotoxicity in surgical patients. Surg Forum. 1976;27(62):125–127. [PubMed] [Google Scholar]
  28. Outteridge P. M., Lepper A. W. Immunosuppressive factors released by transforming lymphocytes in the delayed hypersensitivity skin response to tuberculin. Immunology. 1973 Dec;25(6):981–994. [PMC free article] [PubMed] [Google Scholar]
  29. Rich R. R., Pierce C. W. Biological expressions of lymphocyte activation. 3. Suppression of plaque-forming cell responses in vitro by supernatant fluids from concanavalin A-activated spleen cell cultures. J Immunol. 1974 Apr;112(4):1360–1368. [PubMed] [Google Scholar]
  30. Riddle P. R., Berenbaum M. C. Postoperative depression of the lymphocyte response to phytohaemagglutinin. Lancet. 1967 Apr 8;1(7493):746–748. doi: 10.1016/s0140-6736(67)91364-5. [DOI] [PubMed] [Google Scholar]
  31. Riggio R. R., Schwartz G. H., Bull F. G., Stenzel K. H., Rubin A. L. Alpha-2-globulins in renal graft rejection. Effects of in vitro lymphocyte function. Transplantation. 1969 Nov;8(5):689–694. doi: 10.1097/00007890-196911000-00013. [DOI] [PubMed] [Google Scholar]
  32. Schoenenberger G. A., Burkhardt F., Kalberer F., Müller W., Städtler K., Vogt P., Allgöwer M. Experimental evidence for a significant impairment of host defense for gram-negative organisms by a specific cutaneous toxin produced by severe burn injuries. Surg Gynecol Obstet. 1975 Oct;141(4):555–561. [PubMed] [Google Scholar]
  33. Slade M. S., Simmons R. L., Yunis E., Greenberg L. J. Immunodepression after major surgery in normal patients. Surgery. 1975 Sep;78(3):363–372. [PubMed] [Google Scholar]
  34. Tarnawski A., Batko B. Antibiotics and immune processes. Lancet. 1973 Mar 24;1(7804):674–675. doi: 10.1016/s0140-6736(73)92248-4. [DOI] [PubMed] [Google Scholar]
  35. Vogelfanger I. J., Milthorp P., Behelak Y., Barron P. T., Steele D., Richter M. Naturally occurring immunosuppressive agents. I. The presence in normal pig liver of a factor possessing immunosuppressive properties with respect to pig lymphoid cells in vitro. Transplantation. 1975 Aug;20(2):130–134. [PubMed] [Google Scholar]
  36. Vose B. M., Moudgil G. C. Post-operative depression of antibody-dependent lymphocyte cytotoxicity following minor surgery and anaesthesia. Immunology. 1976 Jan;30(1):123–128. [PMC free article] [PubMed] [Google Scholar]

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