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Modulation of the innate immune response after trauma visualised by a change in functional PMN phenotype

Falco Hietbrink1, Leo Koenderman, Martje Althuizen

  • 1Department of Surgery, University Medical Centre Utrecht, The Netherlands. F.Hietbrink@umcutrecht.nl

Injury
|April 3, 2009
PubMed
Abstract

Insights

Decreased responsiveness of active FcgammaRII on circulating polymorphonuclear granulocytes (PMNs) correlates with injury severity in trauma patients. This finding offers insights into the immune response in critical illness and acute respiratory distress syndrome (ARDS).

Area of Science:

  • Immunology
  • Trauma Research
  • Critical Care Medicine

Background:

  • Acute Respiratory Distress Syndrome (ARDS) is a severe trauma complication driven by excessive inflammation involving polymorphonuclear granulocytes (PMNs).
  • Previous studies show activated lung PMNs in ARDS patients have reduced capacity for FcgammaRII upregulation.
  • This study investigates the link between inflammation severity and diminished FcgammaRII responsiveness in circulating PMNs.

Purpose of the Study:

  • To test the hypothesis that decreased FcgammaRII responsiveness on circulating PMNs correlates with inflammation severity after trauma.
  • To assess PMN immunological capacity as an indicator of injury severity and potential ARDS development.

Main Methods:

  • Fifty-two trauma patients were assessed using injury severity scores and base deficit.
  • Daily inflammation markers were recorded, and fMLP-induced active FcgammaRII on PMNs was measured via FACS analysis within 24 hours of injury.
  • Results were compared to 10 age-matched healthy controls.

Main Results:

  • Baseline PMN expression of Mac-1/CD11b and active FcgammaRII/CD32 did not correlate with injury severity.
  • Interleukin-6 (IL-6) levels significantly correlated with injury severity, confirming a range of inflammatory responses.
  • A significant correlation was found between PMN responsiveness (fMLP-induced active FcgammaRII) and injury severity.
  • Decreased FcgammaRII responsiveness was observed in patients who developed Systemic Inflammatory Response Syndrome (SIRS) or ARDS.

Conclusions:

  • Changes in fMLP-induced active FcgammaRII on circulating PMNs reflect the extent of injury and the innate immune response.
  • This functional PMN phenotype serves as a biomarker for immune alterations post-trauma.
  • Diminished FcgammaRII responsiveness is associated with the development of SIRS and ARDS.

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