Depression of Cellular Immunity After Major Injury: Its Association With Posttraumatic Complications and Its Reversal With Immunomodulation

doi:10.1001/archsurg.1986.01400090026004

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Vol. 121 No. 9, September 1986

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Depression of Cellular Immunity After Major Injury

Its Association With Posttraumatic Complications and Its Reversal With Immunomodulation

Eugen Faist, MD; Thomas S. Kupper, MD; Christopher C. Baker, MD; Irshaud H. Chaudry, PhD; John Dwyer, MD, PhD; Arthur E. Baue, MD

Arch Surg. 1986;121(9):1000-1005.

Abstract

• This study examined a group of surgical patients withrespect to the ability of their peripheral blood mononuclearcells to respond to phytohemagglutinin (PHA). Depression ofthe PHA response of more than 30% below baseline five to sevendays after injury was found in 11 of 19 patients, and eightof them developed infectious complications. The addition ofindomethacin to in vitro cultures resulted in an average enhancementof the PHA response of 37% baseline. Improvement at five toseven days with in vitro indomethacin was from 34% to 74% ininfected patients. These data suggest that major injury canlead to depression of the PHA response, which correlates withthe subsequent development of infectious complications. Indomethacinin vitro seems to be able to reverse or decrease this immunologicdefect and deserves further study.

(Arch Surg 1986;121:1000-1005)

Author Affiliations

From the Department of Surgery, Grosshadern Clinic, Munich (Dr Faist); the Department of Surgery, Yale University School of Medicine, New Haven (Drs Kupper, Baker, Chaudry, and Baue); and the Department of Medicine, Prince of Wales Hospital, Rendwick, New South Wales, Australia (Dr Dwyer).

Footnotes

Accepted for publication March 18, 1986.

Read before the papers session of the Clinical Congress of theAmerican College of Surgeons, San Francisco, Oct 22, 1984.

Reprints not available.

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