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Lymphocyte and complement abnormalities in splenectomized patients with hematologic disorders.
W C Wang1, H G Herrod, W R Valenski
1Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105.
American Journal of Hematology
|August 1, 1988
Summary
Splenectomized patients show impaired B-cell function, leading to reduced IgM synthesis. This immunologic defect may explain their increased risk of infections, particularly from encapsulated bacteria.
Area of Science:
- Immunology
- Hematology
Background:
- Splenectomy, the surgical removal of the spleen, is performed for various hematologic disorders.
- The spleen plays a crucial role in immune surveillance, particularly against encapsulated bacteria.
Purpose of the Study:
- To investigate potential immunologic function and complement level defects in patients who have undergone splenectomy.
- To compare immune function in splenectomized patients with that of functionally asplenic sickle cell patients.
Main Methods:
- Quantification of B cells and T-cell subsets (CD3, CD4) in splenectomized patients.
- In vitro IgM and IgG synthesis assays using peripheral blood mononuclear cells.
- Fractionation studies combining B-cell and T-cell populations from patients and controls.
- Assessment of complement levels (classical and alternative pathways) and complement component H.
Main Results:
- Splenectomized patients exhibited normal absolute numbers of immune cells but slight decreases in CD3 and CD4 cell proportions.
- In vitro IgM synthesis was markedly diminished, while IgG synthesis remained normal.
- B-cell function was found to be defective in splenectomized patients, similar to functionally asplenic sickle cell patients.
- Complement levels were generally normal, with a minor, likely insignificant, decrease in component H.
Conclusions:
- Splenectomized patients have a reduced capacity for IgM synthesis primarily due to defective B-cell function.
- This impaired B-cell function may contribute to the increased susceptibility to infections observed in splenectomized individuals, especially those caused by encapsulated organisms.