This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Lymphocyte activation after non‐thermal trauma. BJS 2000; 87: 223-230.
Published: 10th December 2002
Authors: D. S. Walsh, P. Siritongtaworn, K. Pattanapanyasat, P. Thavichaigarn, P. Kongcharoen, N. Jiarakul et al.
Background
Severe injury causes immunological changes that may contribute to a poor outcome. Longitudinal characterization of lymphocyte response patterns may provide further insight into the basis of these immunological alterations.
Method
Venous blood obtained seven times over 2 weeks from 61 patients with injury severity scores above 20 was assessed for lymphocyte phenotypic and activation markers together with serum levels of interleukin (IL) 2, IL‐4, soluble IL‐2 receptor (sIL‐2R), soluble CD4 (sCD4), soluble CD8 (sCD8) and interferon γ.
Results
Severe injury was associated with profound changes in the phenotypic and activation profile of circulating lymphocytes. Activation was indicated by increased numbers of T cells expressing CD25, CD69 and CD71, and raised serum levels of IL‐2, sIL‐2R, sCD4 and sCD8. Relatively higher levels of sIL‐2R and sCD4 were found in patients with sepsis syndrome.
Conclusion
Polytrauma is associated with dramatic alterations in the phenotypic and activation profile of circulating lymphocytes which are generally independent of clinical course. In contrast, several lymphocyte soluble factors, including sCD4 and sIL‐2R, paralleled the clinical course. These data provide new insight into lymphocyte responses after injury and suggest that further assessment of soluble factors as clinical correlates, including those related to lymphocyte activation or generalized inflammation, may be warranted. © 2000 British Journal of Surgery Society Ltd
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