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Depressed neutrophil chemotaxis in children suffering blunt trauma
P J Krause1, C L Woronick, G Burke
1Department of Pediatrics and Medicine, Hartford Hospital, CT 06102-5037.
Insights
Children suffering blunt trauma exhibit impaired neutrophil function, characterized by the release of immature neutrophils. This dysfunction is similar to that seen in adults and may increase infection risk.
Area of Science:
- Immunology
- Trauma Research
Background:
- Blunt trauma in adults impairs neutrophil (PMN) function, increasing infection risk.
- This impairment is linked to the release of immature neutrophils into circulation.
Purpose of the Study:
- To investigate if children experiencing blunt trauma also exhibit impaired PMN function.
- To determine if immature PMNs are released into circulation in pediatric blunt trauma cases.
Main Methods:
- Assessed PMN chemotaxis and maturation in 25 children and 25 adults post-blunt trauma.
- Utilized a standard micropore filter assay for chemotaxis and a novel monoclonal antibody (31D8) for maturation assessment.
- Compared findings to healthy adult control subjects.
Main Results:
- Blunt trauma patients (children and adults) showed significantly reduced PMN chemotaxis compared to healthy adults.
- PMN chemotactic values improved in both children and adults within 9 days post-trauma.
- Children with trauma had significantly lower PMN 31D8 binding, indicating the presence of immature neutrophils.
Conclusions:
- Children with blunt trauma experience impaired PMN chemotaxis.
- The release of immature neutrophils contributes to this functional deficit in pediatric blunt trauma.
Objective:
Impaired neutrophil (PMN) function, due in part to release of immature PMNs into the circulation, contributes to the increased rate of infection observed in adults suffering blunt trauma. The objective of this study was to determine whether similar events occur in children.
Methods:
We assessed PMN chemotaxis and PMN maturation in 25 children (7 young children and 18 adolescents) and 25 adults 1 to 9 days after suffering blunt trauma, and in healthy adult control subjects. PMN chemotaxis was determined using a standard micropore filter assay, whereas PMN maturation was determined with 31D8, a novel monoclonal antibody that binds to mature PMNs more avidly than immature PMNs and band forms.
Results:
In patients suffering blunt trauma, mean PMN chemotactic values were similar among children (44.6 +/- 2.3 microns) and adults (41.3 +/- 2.1 microns) and both were significantly less than among healthy adults (53.5 +/- 2.4 microns, P < .0005). PMN chemotactic values increased significantly in the 9 days after trauma for both children and adults (F = 13.8, df = 1, P < .0002). Mean PMN 31D8 binding among children with trauma (92.5 +/- 5.2) was significantly less than among healthy adults (117.6 +/- 5.4, P < .0009).
Conclusions:
Impairment in PMN chemotaxis occurs in children after blunt trauma and is due in part to release of immature PMNs into the circulation.