Jf. Sweeney et al., MONOCYTES OVERCOME LYMPHOCYTE DYSFUNCTION IN INJURED ADULTS WITH ELEVATED CANDIDA ANTIGEN TITERS, The journal of trauma, injury, infection, and critical care, 37(6), 1994, pp. 944-949
Objective: Severely injured adults with elevated Candida antigen titer
s have increased mortality from sepsis, in part because of known neutr
ophil (PMN) dysfunction. Since PMN function is modulated by monocytes
and lymphocytes, this study was undertaken to determine the ability of
monocytes and lymphocytes isolated from injured adults with elevated
Candida antigen titers to activate the anticandidal function of normal
PMNs. Methods: Lymphocytes with or without monocytes, isolated from 1
8 injured adults with elevated titers, were cultured in the presence o
r absence of heat-killed Candida albicans for 48 hours. Culture supern
atants were harvested, diluted 1:40, 1:160, and 1:640, and tested for
the ability to stimulate the anticandidal function of normal PMNs usin
g an H-3-glucose incorporation assay. Monocytes and lymphocytes isolat
ed from nine volunteers were studied for comparison. Results: Supernat
ants of lymphocytes from healthy volunteers that were cultured with he
at-killed C. albicans significantly augmented normal PMN anticandidal
function. Supernatants of lymphocytes from injured adults with elevate
d titers that were cultured with heat-killed C. albicans did not signi
ficantly augment normal PMN anticandidal function. Supernatants of mon
ocytes or lymphocytes from both groups of patients were able to upregu
late PMN anticandidal function. Conclusions: Lymphocytes from injured
adults with elevated Candida antigen titers are defective in their abi
lity to stimulate PMN anticandidal function. Monocytes from these pati
ents can respond to Candida exposure and overcome the lymphocyte funct
ional defect seen in injured patients with elevated titers.