RESUMEN
We studied 46 patients who suffered from serious blunt trauma to examine the possible mechanism of their acquired neutrophil (PMN) locomotory dysfunction. Concentrations of plasma C3adesArg were higher in patients than in controls (310 +/- 190 ng/ml vs. 90 +/- 28 ng/ml, respectively; P = 3 X 10(-5)). Both resting and phagocytosing PMNs from the patients produced higher quantities of H2O2 (0.31 +/- 0.29 and 5.2 +/- 3.4 nmol/10(6) PMNs per hr, respectively). These levels resemble the H2O2 production of normal PMNs preactivated with chemotactic factor (0.85 +/- 0.03 for normal and 8.2 +/- 1.6 nmol/10(6) PMNs per hr for preactivated PMNs). Concentrations of oxidized glutathione were not significantly higher in PMNs from patients compared with PMNs from controls (0.053 +/- 0.057 vs. 0.037 +/- 0.046 nmol/10(6) PMNs, respectively; P = .5). A higher percentage of PMNs from trauma patients than from controls were capped with concanavalin A (66% +/- 11% vs. 37% +/- 14%, respectively; P = 4 X 10(-5)), a result indicating microtubular dysfunction. These findings suggest that in trauma, activation of intravascular complement results in inappropriate chemotactic stimulation and subsequent deactivation and autoxidative damage of circulating PMNs.
Asunto(s)
Quimiotaxis de Leucocito , Neutrófilos/fisiología , Heridas no Penetrantes/inmunología , Adolescente , Adulto , Anciano , Activación de Complemento , Complemento C3/análisis , Complemento C3a , Femenino , Glutatión/metabolismo , Humanos , Peróxido de Hidrógeno/metabolismo , Activación de Linfocitos , Masculino , Persona de Mediana Edad , Oxidación-ReducciónRESUMEN
Granulocyte locomotory responses in 5 patients with symptomatic seasonal allergic rhinitis were lower compared with similar responses from 27 normal nonallergic controls. In a subsequent controlled, double-blind crossover study, neither cimetidine (histamine H2-receptor blocker) nor placebo improved these responses. In our in vitro study, histamine did not inhibit granulocyte responses to chemotactic attractant. These results indicate that defective granulocyte response in patients with seasonal allergic rhinitis may be due to factors other than or in addition to histamine.
Asunto(s)
Cimetidina/uso terapéutico , Granulocitos/citología , Rinitis Alérgica Estacional/fisiopatología , Movimiento Celular/efectos de los fármacos , Quimiotaxis , Granulocitos/fisiopatología , Histamina/fisiología , Humanos , Lisosomas/enzimología , Filtros Microporos , Rinitis Alérgica Estacional/tratamiento farmacológicoRESUMEN
Polymorphonuclear leukocyte (PMN) locomotory responses were studied in 24 patients who sustained serious blunt trauma, mostly from motor vehicle accidents. The results showed the presence of a combined cell- and serum-associated locomotory abnormality. The serum abnormality was due to a cell-directed inhibitor, and was present for an average of 3 days. The cell-associated abnormality persisted for approximately 1 week in uninfected patients, and 2 weeks in the infected group. Both mature and immature forms of PMNs contribute to the PMN locomotory dysfunction observed. A significant correlation was observed between the degree of PMN locomotory abnormality or injury severity score and the infection rate. Eighteen infections (six suspected and 12 definite) were observed in 11 of the 24 patients. Twelve (67%) infections involved the lungs. Nine patients (82%) showed evidence of infection by day 6. PMN dysfunction in trauma is associated with increased infection rate and is not due solely to increased numbers of immature forms of PMNs.