Systemic antibacterial mechanisms in trauma

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.