Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1988 Jun;207(6):686–692. doi: 10.1097/00000658-198806000-00007

The capacity of serum to support neutrophil phagocytosis is a vital host defense mechanism in severely injured patients.

H C Polk Jr 1, C D George 1, M J Hershman 1, S R Wellhausen 1, W G Cheadle 1
PMCID: PMC1493541  PMID: 3389936

Abstract

The opsonic capacity of patient serum was studied in 43 trauma patients of whom 13 recovered uneventfully, 21 developed major infection, and nine died, mostly of infection. Blood samples were taken within 24 hours of injury. Fifteen patients were studied serially of whom 14 developed severe infection and/or died. Opsonic capacity was determined by flow cytometry and measured as the ability of normal neutrophils to phagocytose killed bacteria previously incubated with patient serum. The most dilute sera reflected changes for better and worse most clearly. On initial assessment, those who died of sepsis showed a 61% mean fluorescent intensity (MFI), which was significantly lower than the 99% MFI for those who survived infection (p less than 0.01) and the 78% MFI of those who developed no infection (p less than 0.05). Serial samples demonstrated a super serum response in four of seven patients surviving major sepsis but in none of the seven who died of infection.

Full text

PDF
686

Selected References

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

  1. Alexander J. W., McClellan M. A., Ogle C. K., Ogle J. D. Consumptive opsoninopathy: possible pathogenesis in lethal and opportunistic infections. Ann Surg. 1976 Dec;184(6):672–678. doi: 10.1097/00000658-197612000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alexander J. W., Stinnett J. D., Ogle C. K., Ogle J. D., Morris M. J. A comparison of immunologic profiles and their influence on bacteremia in surgical patients with a high risk of infection. Surgery. 1979 Jul;86(1):94–104. [PubMed] [Google Scholar]
  3. Bjornson A. B., Altemeier W. A., Bjornson H. S. Complement, opsonins, and the immune response to bacterial infection in burned patients. Ann Surg. 1980 Mar;191(3):323–329. doi: 10.1097/00000658-198003000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bjornson A. B., Altemeier W. A., Bjornson H. S. Host defense against opportunist microorganisms following trauma. II. Changes in complement and immunoglobulins in patients with abdominal trauma and in septic patients without trauma. Ann Surg. 1978 Jul;188(1):102–108. doi: 10.1097/00000658-197807000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bull J. P. Measures of severity of injury. Injury. 1978 Feb;9(3):184–187. doi: 10.1016/0020-1383(78)90004-9. [DOI] [PubMed] [Google Scholar]
  6. Christou N. V., Meakins J. L. Neutrophil function in anergic surgical patients: neutrophil adherence and chemotaxis. Ann Surg. 1979 Nov;190(5):557–564. doi: 10.1097/00000658-197911000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cohen I. R., Sciutto M. S., Brown G. L., Polk H. C., Jr Failure of opsonization as a sign of lethal sepsis. J Infect Dis. 1984 Apr;149(4):651–651. doi: 10.1093/infdis/149.4.651. [DOI] [PubMed] [Google Scholar]
  8. Goris R. J., Draaisma J. Causes of death after blunt trauma. J Trauma. 1982 Feb;22(2):141–146. doi: 10.1097/00005373-198202000-00011. [DOI] [PubMed] [Google Scholar]
  9. Howard R. J. Prospects for the control of host defenses. Surgery. 1982 Aug;92(2):138–145. [PubMed] [Google Scholar]
  10. Kellerman J. S., Brown G. L., Lamont P. M., Polk H. C., Jr Characterization of neutrophil iodination for the assessment of phagocytic and opsonic function in septic patients. Am J Surg. 1985 Sep;150(3):301–305. doi: 10.1016/0002-9610(85)90065-0. [DOI] [PubMed] [Google Scholar]
  11. Lanser M. E., Mao P., Brown G. E., Mora R., Siegel J. H. Neutrophil chemiluminescence and opsonic fibronectin levels following blunt trauma. J Surg Res. 1986 Sep;41(3):264–273. doi: 10.1016/0022-4804(86)90035-1. [DOI] [PubMed] [Google Scholar]
  12. Lanser M. E., Mao P., Brown G., Coleman B., Siegel J. H. Serum-mediated depression of neutrophil chemiluminescence following blunt trauma. Ann Surg. 1985 Jul;202(1):111–118. doi: 10.1097/00000658-198507000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Maderazo E. G., Albano S. D., Woronick C. L., Drezner A. D., Quercia R. Polymorphonuclear leukocyte migration abnormalities and their significance in seriously traumatized patients. Ann Surg. 1983 Dec;198(6):736–742. doi: 10.1097/00000658-198312000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Maderazo E. G., Woronick C. L., Albano S. D., Breaux S. P., Pock R. M. Inappropriate activation, deactivation, and probable autooxidative damage as a mechanism of neutrophil locomotory defect in trauma. J Infect Dis. 1986 Sep;154(3):471–477. doi: 10.1093/infdis/154.3.471. [DOI] [PubMed] [Google Scholar]
  15. McLoughlin G. A., Wu A. V., Saporoschetz I., Nimberg R., Mannick J. A. Correlation between anergy and a circulating immunosuppressive factor following major surgical trauma. Ann Surg. 1979 Sep;190(3):297–304. doi: 10.1097/00000658-197909000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mealy K., O'Farrelly C., Stephens R., Feighery C. Impaired neutrophil function during anesthesia and surgery is due to serum factors. J Surg Res. 1987 Nov;43(5):393–397. doi: 10.1016/0022-4804(87)90096-5. [DOI] [PubMed] [Google Scholar]
  17. Ozkan A. N., Ninnemann J. L. Reversal of SAP-induced immunosuppression and SAP detection by a monoclonal antibody. J Trauma. 1987 Feb;27(2):123–126. doi: 10.1097/00005373-198702000-00004. [DOI] [PubMed] [Google Scholar]
  18. Polk H. C., Jr, George C. D., Wellhausen S. R., Cost K., Davidson P. R., Regan M. P., Borzotta A. P. A systematic study of host defense processes in badly injured patients. Ann Surg. 1986 Sep;204(3):282–299. [PMC free article] [PubMed] [Google Scholar]
  19. Saba T. M., Blumenstock F. A., Shah D. M., Landaburu R. H., Hrinda M. E., Deno D. C., Holman J. M., Jr, Cho E., Dayton C., Cardarelli P. M. Reversal of opsonic deficiency in surgical, trauma, and burn patients by infusion of purified human plasma fibronectin. Correlation with experimental observations. Am J Med. 1986 Feb;80(2):229–240. doi: 10.1016/0002-9343(86)90014-8. [DOI] [PubMed] [Google Scholar]
  20. Shatney C. H., Benner C. Sequential serum complement (C3) and immunoglobulin levels in shock/trauma patients developing acute fulminant systemic sepsis. Circ Shock. 1985;16(1):9–17. [PubMed] [Google Scholar]
  21. Trunkey D. D. Society of University Surgeons. Presidential address: On the nature of things that go bang in the night. Surgery. 1982 Aug;92(2):123–132. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES