ENDOTOXEMIA AND SPECIFIC ANTIBODY BEHAVIOR AGAINST DIFFERENT ENDOTOXINS FOLLOWING MULTIPLE INJURIES

The aim of this study was to establish the incidence of endotoxemia an d the influence of endotoxin on specific antibody response after multi ple injury. Blood samples were collected from 39 patients (median Inju ry Severity Score: 20.5) at 0-3 and 6-12 hours, and 1, 3, 5, and 10 da ys after admission. The endotoxin plasma levels were high at the first time point (mean = 0.421 endotoxin units/mL) and decreased in the lat er course. Total immunoglobulin levels of IgM, IgG, or IgA were low an d increased throughout the observation period. Specific antibodies of the IgM class against two lipid A and four lipopolysaccharide preparat ions increased transiently but significantly on day 3 and/or day 5. No changes of specific antibody content against endotoxin or lipid A was seen in the IgG or IgA class. The specific antibody content of the di fferent classes against alpha-hemolysin of Staphylococcus aureus did n ot differ during 10 days after trauma. The specific antibodies of the IgM class reacted with ail lipid A and LPS lipopolysaccharide preparat ions demonstrating cross-reactivity. These results suggest that endoto xin may be a specific stimulator of IgM antiendotoxin antibody secreti on following trauma.