Host resistance in sepsis and trauma

Area of Science:

• Immunology
• Clinical Medicine
• Surgical Research

Background:

• Host resistance to infection is crucial in critically ill and surgical patients.
• Assessing cellular immunity is vital for predicting patient outcomes.
• Delayed hypersensitivity is a key indicator of cell-mediated immunity.

Purpose of the Study:

• To evaluate the correlation between in vivo delayed hypersensitivity responses and infection incidence in seriously ill and preoperative patients.
• To determine if immune anergy predicts infection, septicemia, and mortality.
• To explore the potential of immune status assessment for risk stratification and therapeutic intervention.

Main Methods:

• In vivo delayed hypersensitivity testing using 5 antigens.
• Dinitrochlorobenzene (DNCB) skin sensitivity and challenge tests.
• Assessment of infection, septicemia, and mortality in 55 seriously ill/injured and 50 preoperative patients.

Main Results:

• A significant correlation was observed between anergy (lack of immune response) and increased rates of infection, septicemia, and death.
• Anergy was predictive of these adverse outcomes in both postoperative/post-injury and preoperative cohorts.
• Protein-calorie malnutrition was present but did not significantly differentiate anergic from non-anergic patients.

Conclusions:

• In vivo measurement of delayed hypersensitivity is a valuable tool for assessing infection risk in seriously ill and preoperative patients.
• Immune modulation strategies targeting cell-mediated immunity may reduce infection-related complications.
• Identifying anergy preoperatively can guide interventions to improve patient outcomes.