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Chemiluminescence: comparison of whole blood with isolated polymorphonuclear leukocytes after major trauma
Ian Pallister1, Nicholas Topley
1Department of Trauma & Orthopaedics, Morriston Hospital, Morriston, Swansea, England, United Kingdom. ianpallister@hotmail.com
Introduction:
Neutrophil (PMN) mediated tissue injury is central to the development of post-traumatic ARDS/MOF. Changes in activity caused by PMN isolation may be avoided by studying respiratory burst activity using whole blood chemiluminescence (WBCL).
Methods:
WBCL and PMNCL were measured in 5 normal laboratory volunteers (NLV) and 9 patients sustaining major trauma, within 2 hours of admission. Receptor mediated (STZ) and independent (PMA) activating agents were used.
Results:
PMA activation confirmed significant priming both in WBCL and PMNCL after major trauma. With STZ, priming was confirmed in the WBCL study, but the trauma patient PMNCL showed no difference in response to those of NLV. Although the study population was small, those patients later developing ARDS demonstrated significantly greater STZ activated WBCL, 8 hours after admission.
Conclusion:
PMN isolation alters behavior in vitro. This may lead to important differences of in vivo PMN function being obscured when studied in the laboratory setting. Further study of CL response and surface receptor expression is clearly warranted, both in WB and PMN preparations.
Insights
Whole blood chemiluminescence (WBCL) better reflects neutrophil function after trauma than isolated neutrophils. WBCL may predict acute respiratory distress syndrome (ARDS) development in trauma patients.
Area of Science:
- Immunology
- Trauma Research
- Respiratory Medicine
Background:
- Neutrophil (PMN) mediated tissue injury is critical in post-traumatic acute respiratory distress syndrome (ARDS) and multiple organ failure (MOF).
- Studying respiratory burst activity using whole blood chemiluminescence (WBCL) may circumvent alterations in PMN activity caused by isolation.
Purpose of the Study:
- To compare PMN respiratory burst activity in whole blood versus isolated PMN preparations in trauma patients.
- To assess the utility of WBCL in evaluating PMN function following major trauma and its potential to predict ARDS development.
Main Methods:
- WBCL and PMN chemiluminescence (PMNCL) were measured in normal laboratory volunteers (NLV) and major trauma patients within 2 hours of admission.
- Receptor-mediated (STZ) and independent (PMA) activating agents were utilized to stimulate PMN activity.
Main Results:
- PMA activation showed significant PMN priming in both WBCL and PMNCL post-trauma.
- STZ activation confirmed priming in WBCL, but not in PMNCL, suggesting isolation artifacts.
- Patients who later developed ARDS exhibited significantly greater STZ-activated WBCL 8 hours post-admission.
Conclusions:
- PMN isolation in vitro can obscure in vivo functional differences, impacting the study of neutrophil behavior.
- WBCL offers a more accurate assessment of PMN function in the context of trauma compared to isolated PMN studies.
- Further investigation into CL response and surface receptor expression in both WB and PMN preparations is warranted.
