A BIOLOGIC BASIS FOR ALTERED HOST DEFENSES IN SURGICALLY INFECTED ABSCESSES

Objective This study determines whether there are any differences in s everal immunologic parameters in circulating peripheral blood leukocyt es, serum, and plasma compared with pus leukocytes, and supernatant of various types of abscess. Summary Background Data Although there have been reports of high lysozyme levels and low complement levels within pus, there has been no systemic comparison of concentrations of these substances and others within pus compared with those within periphera l blood. Methods Peripheral blood and abscess pus were collected from 31 patients with abscesses and percent and mean channel of monocytes e xpressing complement receptor and major histocompatibility antigen HLA -DR, the percent and mean channel of polymorphonuclear leukocytes (PMN ) expressing complement receptor, lysozyme level, and levels of total hemolytic complement, iC3b, C5b-9, and immunoglobulins were measured w ithin both pus and peripheral blood. Results Percent of monocytes expr essing HLA-DR and percent of monocytes and PMN expressing complement r eceptor, total hemolytic complement, and IgM were reduced within pus c ompared with peripheral blood, whereas the mean channel of monocytes e xpressing HLA-DR and the mean channel of PMNs expressing CR3, C5b-9, a nd lysozyme were increased in pus. Conclusions There are marked differ ences in immunologic parameters measured within pus of abscesses versu s that seen in peripheral blood.