M. Ditschkowski et al., Reduced B cell HLA-DR expression and natural killer cell counts in patients prone to sepsis after injury, EURO J SURG, 165(12), 1999, pp. 1129-1133
Objective: To examine the influence of natural killer (NK) cells and HLA-DR
molecules on B cells in the development of severe sepsis after injury.
Design: Prospective study.
Setting: Medical school, Germany.
Subjects: 46 severely injured (Injury Severity Score >16) patients.
Interventions: Blood samples were taken immediately after admission and sub
sequently for 14 days.
Main outcome measures: HLA-DR expression on B cells and counts of B and NK
cells measured by how cytometry, and morphological estimation of large gran
ular lymphocytes by microscopy.
Results: HLA-DR expression on circulating B cells was significantly reduced
from days 6-14 after admission in 13 patients with subsequent severe sepsi
s compared with 33 patients who did not develop sepsis. In septic patients
NK cell counts were significantly decreased from day 4 onwards (p < 0.05).
CD16+/CD56+ cells correlated with the morphology of large granular lymphocy
tes.
Conclusion: In severely injured patients reduced counts of NK cells and HLA
-DR molecules on B lymphocytes seem to be part of an immune deviation that
is associated with the development of severe sepsis.