OPSONIC ACTIVITY OF SERA AND BLISTER FLUID FROM SEVERELY BURNED PATIENTS EVALUATED BY A CHEMILUMINESCENCE METHOD

Burn wound sepsis is the most common and severe complication in the pa tients with severe burn. To know the systemic and local defect in immu nity of burned patients, we measured the luminol-enhanced chemilumines cence (CL) response of normal polymorphonuclear leukocytes (PMNs) upon exposure to zymosan particles, bacteria or Candida albicans that were opsonized with any of patient's serum, blister fluid of burn wound or pooled normal serum (blood type AB). Sera from patients exhibited low er opsonic activities than those of pooled normal serum in the early p ostburn days. The levels of serum immunoglobulins, complement componen ts and plasma fibronectin were found to correlate well with opsonin-in dex (OI), which was determined based on the CL response data obtained during the course of infusion therapy with fresh frozen plasma. Furthe rmore, patient's blister fluid showed much lower opsonic; activity aga inst bacteria such as Pseudomonas aeruginosa than patient's own serum. These results indicate that blister fluid is also not effective to op sonize bacteria because of the marked depression of the levels of immu noglobulins and complement components. Destruction of the skin barrier by thermal injury and impairment of systemic or local humoral immunit y may predispose these patients to burn wound sepsis.