Characteristics of Neutrophil Dysfunction

  • G. F. Babcock
  • C. L. White-Owen
  • J. W. Alexander
  • G. D. Warden


Overwhelming sepsis is a major source of morbidity and mortality in patients following severe thermal injury or other traumatic injury. Despite this fact, the mechanisms underlying these potentially fatal complications have not been elucidated. It is likely that at least some of these altered immunological parameters are associated with infections and sepsis. Several lines of investigation have implicated neutrophil dysfunction as one of the major causes of increased infection rates in groups of patients. Since that time several reports have established a relationship between abnormal neutrophil functions and the development of life-threatening infections [1], whereas other investigators have failed to find high correlations between the defects and patient mortality [2, 3]. However, several laboratories, including our own, have found a significant correlation between the degree of the neutrophil dysfunction and the morbidity of the patient [4, 5].


Trauma Patient Thermal Injury Total Body Surface Area Neutrophil Phagocytosis Neutrophil Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Alexander JW, Ogle CK, Stinnett J, MacMillan BG (1978) A sequential prospective analysis of immunological abnormalities and infection following severe thermal injury. Ann Surg 188:809–816PubMedCrossRefGoogle Scholar
  2. 2.
    Deitch E. McDonald J (1982) Influence of serum on impaired neutrophil Chemotaxis after thermal injury. J Surg Res 33:251–257PubMedCrossRefGoogle Scholar
  3. 3.
    Christou NV, Tellado JM (1989) In vitro polymorphonuclear neutrophil function in surgical patients does not correlate with anergy but with “activating” processes such as sepsis or trauma. Surgery 106:718–724PubMedGoogle Scholar
  4. 4.
    Alexander JW, Stinnett JD, Ogle C, Ogle JD, Morris M (1979) A comparison of immunologic profiles and their influence on bacteremia in surgical patients with a high risk of infection. Surgery 86:94–104PubMedGoogle Scholar
  5. 5.
    Alexander JW, Ogle CK, Stinnett JD, White M, Morris M, MacMillan BG (1979) Relationship between host defence variables and infection in severe thermal injury. Burns 5:248–254CrossRefGoogle Scholar
  6. 6.
    Warden G, Mason A, Pruitt B (1974) Evaluation of leukocyte Chemotaxis in vitro in thermally injured patients. J Clin Invest 54:1001–1004PubMedCrossRefGoogle Scholar
  7. 7.
    Grogan J (1976) Suppressed in vitro Chemotaxis of burn neutrophils. J Trauma 16:985–988PubMedCrossRefGoogle Scholar
  8. 8.
    Davis J, Dineen P, Gallin J (1980) Neutrophil degranulation and abnormal Chemotaxis after thermal injury. Annu Rev Med 124:1467–1471Google Scholar
  9. 9.
    Alexander JW, Wixson J (1970) Neutrophil dysfunction and sepsis in burn injury. Surg Gynecol Obstet 130:431PubMedGoogle Scholar
  10. 10.
    Curreri PW, Heck E, Browne L, Baxter C (1973) Stimulated nitro blue tetrazolium test to assess neutrophil antibacterial function: prediction of wound sepsis in burned patients. Surgery 74:6–13PubMedGoogle Scholar
  11. 11.
    Ogle C, Alexander JW, Nagy H, Wood S, Palkert D, Carey M, Ogle J, Warden G (1990) A long-term study and correlation of lymphocyte and neutrophil function in the patient with burns. J Burn Care Rehabil 11:105PubMedCrossRefGoogle Scholar
  12. 12.
    Grogan J (1976) Altered neutrophil phagocytic function in burn patients. J Trauma 16:734–738PubMedCrossRefGoogle Scholar
  13. 13.
    Heck E, Edgar M, Hunt J, Baxter C (1980) A comparison of leukocyte function and burn mortality. J Trauma 20:75–77PubMedGoogle Scholar
  14. 14.
    Bjerknes R, Vindenes H, Pitkanen J, Winneman J, Laerum OD, Abyholm F (1989) Altered polymorphonuclear neutrophilic granulocyte functions in patients with large burns. J Trauma 29:847–855PubMedCrossRefGoogle Scholar
  15. 15.
    Heck E, Browne L, Curreri PW, Baxter C (1975) Evaluation of leukocyte function in burned individuals by in vitro oxygen consumption. J Trauma 15:486–488PubMedCrossRefGoogle Scholar
  16. 16.
    Duque R, Phan S, Hudson J, Till G, Ward P (1985) Functional defects in phagocytic cells following thermal injury. Am J Pathol 118:116–127PubMedGoogle Scholar
  17. 17.
    Gadd M, Hansbrough J (1989) The effect of thermal injury on murine neutrophil oxidative metabolism. J Burn Care Rehabil 10:125–130PubMedCrossRefGoogle Scholar
  18. 18.
    Bjerknes R, Vindenes H (1989) Neutrophil dysfunction after thermal injury: alteration of phagolysosomal acidification in patients with large burns. Burns 15:77–81PubMedCrossRefGoogle Scholar
  19. 19.
    Gallin J (1985) Neutrophil specific granule deficiency. Annu Rev Med 36:263–274PubMedCrossRefGoogle Scholar
  20. 20.
    Piller N (1976) A comparison of the effect of benzopyrones and other drugs with antiinflammatory properties on acid and neutral protease activity levels in various tissues after thermal injury. Br J Exp Pathol 57:411–418PubMedGoogle Scholar
  21. 21.
    Koller M, Konig W, Brom J, Erbs G, Muller F (1989) Studies on the mechanisms of granulocyte dysfunctions in severely burned patients — evidence for altered leukotriene generation. J Trauma 29:435–445PubMedCrossRefGoogle Scholar
  22. 22.
    Rothe G, Kellerman W, Valet G (1990) Flow cytometric parameters of neutrophil function as early indicators of sepsis- or trauma-related pulmonary or cardiovascular organ failure. J Lab Clin Med 115:52–61PubMedGoogle Scholar
  23. 23.
    Warden G, Mason A, Pruitt B (1975) Suppression of leukocyte Chemotaxis in vitro by chemotherapeutic agents used in the management of thermal injuries. Ann Surg 181:863–869CrossRefGoogle Scholar
  24. 24.
    Bjornson A, Bjornson HS, Altemeier W (1981) Serum-mediated inhibition polymorphonuclear leukocyte function following burn injury. Ann Surg 194:568–575PubMedCrossRefGoogle Scholar
  25. 25.
    Deitch E, Gelder F, McDonald J (1982) Prognostic significance of abnormal neutrophil Chemotaxis after thermal injury. J Trauma 22:199–204PubMedCrossRefGoogle Scholar
  26. 26.
    Jeyapaul J, Mehta N, Arora S, Antia N (1984) Fc and complement receptor integrity of polymorphonuclear (PMN) cells following thermal injury. Burns 10:387–395CrossRefGoogle Scholar
  27. 27.
    Alexander JW (1967) Serum and leukocyte lysosomal enzyme derangements following severe thermal injury. Arch Surg 95:482–490PubMedCrossRefGoogle Scholar
  28. 28.
    Babcock GF, Taylor AF, Hynd B, Sramkoski RM, Alexander JW (1987) Flow cytometric analysis of lymphocyte subset phenotypes comparing normal children and adults. Diagn Clin Immunol 5:175–179PubMedGoogle Scholar
  29. 29.
    Babcock GF, Alexander JW, Warden GD (1990) Flow cytometric analysis of neutrophil subsets in thermally injured patients developing infection. J Clin Immunol Immunopathol 54:117–125CrossRefGoogle Scholar
  30. 30.
    White-Owen C, Babcock GF, Sramkoski RM, Alexander JW (1991) A rapid whole blood microassay for human neutrophil phagocytosis of FITC-labeled Staphylococcus aureus using flow cytometry. (submitted for publication)Google Scholar
  31. 31.
    Bass D, Parce J, Dechatelet L, Szejda P, Seeds M, Thomas M (1983) Flow cytometric studies of oxidative product formation by neutrophils: a graded response to membrane stimulation. J Immunol 130:1910–1917PubMedGoogle Scholar
  32. 32.
    White-Owen C, Alexander JW, Babcock GF (1991) Reduced expression of neutrophil CD11b and CD16 after severe trauma. J Surg Res (in Press)Google Scholar
  33. 33.
    White-Owen C, Babcock GF, Alexander JW (1990) Identification of a subpopulation of human neutrophils with altered phagocytic capacity in patients suffering severe thermal or traumatic injury. 6th International Symposium on Infections in the Immunocompromised Host 6:175 (Abstract)Google Scholar
  34. 34.
    White-Owen C, Alexander JW, Babcock GF (1990) Phagocytosis by CD11b-CD16- neutrophils. J Leukocyte Biol 1 [Suppl]:48Google Scholar
  35. 35.
    Smith CL, Baker CJ, Anderson DC, Edwards MS (1990) Role of complement receptors in opsonophagocytosis of group B streptococci by adult and neonatal neutrophils. J Infect Dis 162:489–495PubMedCrossRefGoogle Scholar
  36. 36.
    Graham I, Brown E (1991) Extracellular calcium results in a conformational change in Mac-1 (CD1 lb/CD 18) on neutrophils: differentiation of adhesion and phagocytosis function of Mac-1. J Immunol 146:685–691PubMedGoogle Scholar
  37. 37.
    Salmon J, Brogle N, Edberg J, Kimberly R (1991) Fcγ receptor III induces actin polymerication in human neutrophils and primes phagocytosis mediated by Fcγ receptor II. J Immunol 146:997–1004PubMedGoogle Scholar

Copyright information

© Springer-Verlag, Berlin Heidelberg 1993

Authors and Affiliations

  • G. F. Babcock
    • 1
  • C. L. White-Owen
    • 1
  • J. W. Alexander
    • 1
  • G. D. Warden
    • 1
  1. 1.Department of Surgery, and Shriners Burns InstituteUniversity of Cincinnati Medical CenterCincinnatiUSA

Personalised recommendations