SEQUENTIAL SYSTEMIC PLATELET-ACTIVATING-FACTOR AND INTERLEUKIN-8 PRIMES NEUTROPHILS IN PATIENTS WITH TRAUMA AT RISK OF MULTIPLE ORGAN FAILURE

Plasma from 33 patients at risk of multiple organ failure (MOF) after major trauma was tested for a priming effect on neutrophils, and for t he presence of platelet-activating factor (PAF) activity and interleuk in (IL) 8. Plasma sampled at 3, 6, 12 and 24 h after injury significan tly primed normal neutrophils to release mean(s.e.m.) 1.26(0.19), 1.33 (0.26), 1.04(0.14) and 0.86(0.13) nmol superoxide per min per 1.3 x 10 (6) neutrophils respectively (P<0.05). Priming at 3 h after injury was inhibited by mean(s.e.m.) 63.8(7.0) per cent by the PAF antagonist, W EB 2170 (P<0.01). Mean(s.e.m.) plasma IL-8 was raised at 6 and 12 h af ter injury to 785(183) and 836(175) pg/ml (P<0.01). At 12 h after inju ry the plasma IL-8 level correlated directly with the number of units of red blood cells transfused (r=0.64, P<0.01), and was significantly higher in the group of six patients who developed MOF (P<0.05). These data suggest that after trauma the mediators PAF and IL-8 appear seque ntially in the circulation, are potential mechanisms of circulating ne utrophil priming, and that IL-8 may also be an early biochemical marke r predicting the onset of MOF.