Mechanisms of immunosuppression associated with severe nonthermal traumatic injuries in man: Production of interleukin 1 and 2

Abstract

Depression of cell-mediated immunity in patients following severe traumatic injury has been well documented in vitro and in vivo. However, the exact mechanism of this defect is still controversial. In this study, we have investigated the ability of injured patients' peripheral blood mononuclear cells (PBMC) to produce two important immunoregulatory molecules, interleukin 1 (IL 1) and interleukin 2 (IL 2). Eighteen traumatic injury patients were studied during the course of their hospital stay and their results compared with a group of 18 normal age- and sex-matched controls. The results showed the following. (1) Production of IL 2 by normal PBMC in response to optimal doses of mitogen may vary with sex as well as age. (2) Adherent mononuclear cells from trauma patients produced at least as much IL 1 as normals. (3) IL 2 production, however, was markedly suppressed (normals, 1.6 +/- 0.2 U; traumatic injury, 0.6 +/- 0.1 U; P = 0.001) and persisted for as long as 50 days postinjury. OKT4+ cells were not significantly decreased at any time, nor were OKT8+ suppressor/cytotoxic cells increased at any time. Decreased IL 2 production in patients treated with steroids or those who were septic was not different from that in those patients who were not treated with steroids or were not septic. These results suggest that the cause of the defect in IL 2 production in traumatic injury patients is not related to a lack of the IL 1 signal, producer T cells, or Ia+ monocytes or to increased suppressor T cells.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of ranitidine on postoperative infectious complications following emergency colorectal surgery: A randomized, placebo-controlled, double-blind trial

“…Transient impairment in immunocompetence is induced by major surgery, trauma, and burns [6][7][8], and preoperative and postoperative immunosuppression correlates with the risk of developing postoperative infectious complications [9][10][11][12]. The mechanism leading to trauma-induced immunosuppression is still only partially elucidated, but several peptides and suppressor molecules [13,14] are thought to be involved in the process in which down-regulation of interleukin-2 (IL-2) production and release plays a key role [15,16].…”

Depressed Interferon Gamma Production and Monocyte HLA-DR Expression After Severe Injury

“…ulated interferon gamma production were measured sequentially on days 1,3,7,14, and 21 after admission in 20 multiply injured patients (mean Injury Severity Score, 33). Ten patients recovered uneventfully and ten developed a major infection, three of whom died.…”

Alterations of Cellular Immunity and Antibody Responses after Severe Head Injury in Children

“…These include depressed delayed hypersensitivity skin tests,4 decreased response of lymphocytes to mitogens,5 decreases in numbers of T cells and T helper cells,6 and decreased production of IL-2. 7 Accidents cause half of all deaths in children between I and 15 years old. 8 Blunt trauma is responsible for over 80% of the serious injuries in children,9 with head injuries occurring more often in children than in adults.…”