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Increased rigidity and priming of polymorphonuclear leukocytes in sepsis

E M Drost1, G Kassabian, H J Meiselman

  • 1Departments of Medicine and of Physiology and Biophysics, University of Southern California School of Medicine, Los Angeles, California, USA.

American Journal of Respiratory and Critical Care Medicine
|June 3, 1999
PubMed

Insights

Polymorphonuclear leukocytes (PMN) show increased rigidity in severe sepsis, potentially causing organ dysfunction. This PMN rigidity improved in survivors, correlating with clinical recovery, suggesting a link to sepsis progression.

Area of Science:

  • Immunology
  • Pathophysiology
  • Biomedical Engineering

Background:

  • Abnormal mechanical properties of polymorphonuclear leukocytes (PMN) may contribute to capillary retention in sepsis.
  • This retention can lead to organ dysfunction during severe sepsis.

Purpose of the Study:

  • To determine if PMN rigidity increases in severe sepsis.
  • To investigate the correlation between PMN rheologic behavior and the clinical course of sepsis.

Main Methods:

  • Micropore filtration using a cell transit analyzer to assess PMN deformation.
  • Studied 18 adults with severe sepsis over 14 days, comparing them to 5 healthy controls.

Main Results:

  • PMN rigidity was 2.5-fold greater in sepsis patients on Day 0 (p < 0.001).
  • PMN rigidity improved in recovering patients but not in those who died, correlating with clinical indicators.
  • Patient PMN showed a 5-fold greater rigidity increase in response to fMLP compared to controls.

Conclusions:

  • Circulating PMN are more rigid and primed for augmented chemotactic response in severe sepsis.
  • Cytokine-mediated increases in PMN rigidity may cause capillary sequestration and impair microvascular perfusion in sepsis.

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