SOME ASPECTS OF THE HUMORAL AND NEUTROPHIL FUNCTIONS IN POST-COMATOSEUNAWARENESS PATIENTS

Post-comatose unawareness (PCU) is one of the possible outcomes of sev ere brain injury. Patients with severe brain injury have an increased susceptibility to severe nosocomial infections for multifactorial reas ons, including immune suppression at different levels. We studied diff erent immunological aspects in 11 PCU patients. Impaired humoral immun ity was found in 27% of them. Two patients had decreased haemolytic ac tivity of the classical complement pathway, associated with decreased levels of the components C1q, C1r and C4. Another patient had very low levels of IgG2 and IgG4. The neutrophil killing activity was impaired in these three patients, but was completely restored with the additio n of a heterologous serum, suggesting a humoral defect. Neutrophils sh owed normal chemotaxis and random migration, and the superoxide anion release by neutrophils was also found to be normal. Understanding the immunological events in PCU patients contributes to a better and more intensive therapeutic approach, which might accelerate the rehabilitat ion of these patients.