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Activation state of polymorphonuclear leukocytes in surgical patients: characterization of surface receptor
1Department of Surgery, McGill University, Montreal, Quebec, Canada.
Background:
We studied the expression of chemotactic, opsonic, and adherent receptors on the membranes of polymorphonuclear neutrophils (PMNs) from surgical patients because modulation of these receptors has been suggested in the control of critical PMN functions that directly or indirectly influence patient outcome.
Methods:
Healthy subjects who had PMN adherence, chemotaxis, and receptor measurements were compared with preoperative surgical patients and those who were within 48 hours of an admission to an intensive care unit (surgical intensive care unit) because of an acute illness.
Results:
The following receptor/cell pattern was found in control subjects, preoperative patients, and patients in the surgical intensive care unit, respectively: formyl peptide (13,000 vs 18,000 vs 22,000), CR3 (59,000 vs 105,000 vs 121,000), fibronectin (21,000 vs 20,000 vs 35,000), FcII gamma (9,000 vs 20,000 vs 25,000), C5a (347 vs 265 vs 250 mean channel number), and FcIIIR (64,000 vs 75,000 vs 26,000). This receptor pattern was partly correlated directly or indirectly with the acute-phase response, neutrophil adherence, and PMN chemotaxis from these subjects.
Conclusions:
The data suggest that there are alterations in the expression and modulation of PMN surface membrane receptors in patients with a "stable" disease process compared with those with an acute illness, which may affect critical PMN functions needed to combat bacterial infections.
Insights
Polymorphonuclear neutrophil (PMN) receptor expression changes in surgical patients, especially those acutely ill, impacting immune function. These findings highlight altered PMN receptors in critical illness, affecting the body's ability to fight infections.
Area of Science:
- Immunology
- Cell Biology
- Critical Care Medicine
Background:
- Polymorphonuclear neutrophils (PMNs) play a crucial role in patient outcomes through their functions.
- Modulation of PMN surface receptors is implicated in controlling these critical functions.
Purpose of the Study:
- To investigate the expression of chemotactic, opsonic, and adherent receptors on PMNs.
- To compare receptor expression in healthy individuals, preoperative surgical patients, and critically ill patients.
Main Methods:
- Compared receptor expression, adherence, and chemotaxis in healthy subjects, preoperative surgical patients, and patients in the surgical intensive care unit.
- Measured specific receptors including formyl peptide, CR3, fibronectin, FcII gamma, C5a, and FcIIIR.
Main Results:
- Significant alterations in PMN surface receptor expression were observed across the groups.
- Receptor patterns correlated with the acute-phase response, neutrophil adherence, and PMN chemotaxis.
- Patients in the surgical intensive care unit showed distinct receptor expression profiles compared to controls and preoperative patients.
Conclusions:
- PMN surface membrane receptors are altered in patients with stable disease and acute illness.
- These alterations may impact critical PMN functions necessary for combating bacterial infections.