The Immune Consequences of Trauma: An Overview

  • J. L. Ninnemann

Abstract

Trauma, considered as a whole, remains the greatest single killer of the US adult population. A significant component of mortality after injury is due to an induced immunological deficiency, a defect responsible for septic death. While discussion of immune deficiency states usually brings to mind AIDS, or well defined congenital diseases, there has been increasing interest in and concern for immunological depression acquired as a result of accidental or operative injury in an otherwise normal host. An excellent recent sampling of the literature, for example, can be found in the November/December 1987 issue of the Journal of Burn Care and Rehabilitation, which contains papers from a recent conference on the subject. The material for this review, in fact, is taken from one of the papers in this volume (Ninnemann 1987). In the case of major injuries, immunological changes can be precipitous and leave the host vulnerable to life-threatening sepsis. Fortunately, however, injury induced immune depression is completely reversible, and with an understanding of its causes has come the hope of controlling immunity in favor of the host.

Keywords

Migration Depression Carbohydrate Lymphoma Prostaglandin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baker CC, Oppenheimer L, Stephens B, Lewis FR, Trunkey DD (1980) Epidemiology of trauma deaths. Am J Surg 140: 144–150PubMedCrossRefGoogle Scholar
  2. Christou NV, Meakins JL (1979) Neutrophil function in surgical patients: two inhibitors of granulocyte chemotaxis associated with sepsis. J Surg Res 26: 355–364PubMedCrossRefGoogle Scholar
  3. Christou NV, Meakins JL (1982) Phagocytic and bactericidal functions of polymorphonuclear neutrophils from anergic surgical patients. Can J Surg 25: 444–448PubMedGoogle Scholar
  4. Christou NV, Meakins JL (1983) Partial analysis and purification of polymorphonuclear neutrophil chemotactic inhibitors in serum from anergic patients. Arch Surg 18: 156–160Google Scholar
  5. Christou NV, Yurt RW (1983) Anergy testing in surgical patients. Infect Surg Oct: 692–700Google Scholar
  6. Christou NV, Superina R, Broadhead M, Meakins JL (1982) Postoperative depression of host resistance: determinants and effect of peripheral protein-sparing therapy. Surgery 92: 786–792PubMedGoogle Scholar
  7. Fabricius E, Stahn R, Fabricius HA (1980) Funktionsstörungen des thymusabhängigen Immunsystems nach operativen Eingriffen. Fortschr Med 98: 7630–7633Google Scholar
  8. Greco RS, Dick L, Duckenfeld J (1978) Perioperative suppression of the leukocyte migration inhibition assay in patients undergoing elective operations. Surg Gynecol Obstet 147: 717–720PubMedGoogle Scholar
  9. Hansbrough JF, Zapata-Sirvent R, Peterssen V, Bender EM, Claman HN (1985) Modulation of suppressor cell activity and improved resistance to infection in the burned mouse. J Burn Care Rehabil 6: 270–274PubMedCrossRefGoogle Scholar
  10. Howard RJ (1979) Effect of burn injury, mechanical trauma, and operation on immune defenses. Surg Clin North Am 59: 199–211PubMedGoogle Scholar
  11. Keane RM, Munster AM, Birmingham W (1982) Suppressor cell activity after major injury: indirect and direct functional assays. J Trauma 22: 770–773PubMedCrossRefGoogle Scholar
  12. Keane RM, Birmingham W, Shatney CM, Winchurch RA, Munster AM (1983) Prediction of sepsis in the multi-traumatic patient by assays of lymphocyte dysfunction. Surg Gynecol Obstet 156: 163–167PubMedGoogle Scholar
  13. Ninnemann JL (ed) (1981) The immune consequences of thermal injury. Williams and Wilkins, BaltimoreGoogle Scholar
  14. Ninnemann JL (1982) Immunologic defenses against infection: alterations following thermal injuries. J Burn Care Rehabil 3: 355–366CrossRefGoogle Scholar
  15. Ninnemann JL (ed) (1983) Traumatic injury: infection and other immunologic sequelae. University Park Press, BaltimoreGoogle Scholar
  16. Ninnemann JL (1987) Trauma, sepsis, and the immune response. J Burn Care Rehabil 8: 462–468PubMedGoogle Scholar
  17. O’Mahoney JB, Palder SB, Wood JJ, Mclrvine A, Rodrick ML, Demling RH, Mannick JA (1984) Depression of cellular immunity after multiple trauma in the absence of sepsis. J Trauma 24: 869–875CrossRefGoogle Scholar
  18. Polk HC (1979) Consensus summary on infection. J Trauma 19 [Suppl]: 894–896PubMedGoogle Scholar
  19. Salo M (1978) Effect of anaesthesia and open heart surgery on lymphocyte responses to phytohemagglutinin and concanavalin A. Acta Anasthesiol Scand 22: 471–439CrossRefGoogle Scholar
  20. Slade MS, Simmons RL, Yunis E, Greenburg LJ (1975) Immunodepression after major surgery in normal patients. Surgery 78: 363–372PubMedGoogle Scholar
  21. Tarpley JL, Twomey PL, Catalona WJ, Chretien PB (1977) Suppression of cellular immunity by anesthesia and operation. J Surg Res 22: 195–201PubMedCrossRefGoogle Scholar
  22. Wang BS, Heacock EH, Wu AVO, Mannick JA (1980) Generation of suppressor cells in mice after surgical trauma. J Clin Invest 66: 200–209PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag, Berlin Heidelberg 1989

Authors and Affiliations

  • J. L. Ninnemann

There are no affiliations available

Personalised recommendations