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Reduced B cell HLA-DR expression and natural killer cell counts in patients prone to sepsis after injury
M Ditschkowski1, E Kreuzfelder, M Majetschak
1Institute of Immunology, University Hospital of Essen, Germany.
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 subsequently for 14 days.
Main Outcome Measures:
HLA-DR expression on B cells and counts of B and NK cells measured by flow cytometry, and morphological estimation of large granular 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 sepsis 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 lymphocytes.
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.