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John F. Sweeney, MD; Alexander S. Rosemurgy, MD; Sheng Wei, MD; Julie Y. Djeu, PhD

Arch Surg. 1993;128(1):40-46.

Abstract
• Per protocol, adults with an Injury Severity Score of 18 or greater underwent Candida antigen titer measurements weekly. If titers were 1:4 or greater, neutrophil function against Candida albicans was determined with use of a tritiated glucose incorporation assay, and polymorphonuclear leukocytes obtained from healthy blood donors were studied concurrently for comparison. Polymorphonuclear leukocytes from healthy blood donors and injured patients with elevated titers were able to inhibit C albicans growth in a dose-dependent fashion. Polymorphonuclear leukocytes from injured patients with elevated titers had a significantly depressed ability to inhibit C albicans growth compared with those from healthy blood donors at all effector cell—to—target cell ratios tested. Cytokine-treated polymorphonuclear leukocytes from healthy blood donors and injured patients with elevated Candida antigen titers demonstrated significantly improved anticandidal activity at all ratios of polymorphonuclear leukocytes—to–Candida. Granulocyte macrophage—colony stimulating factor was the most potent cytokine at reconstituting polymorphonuclear leukocyte function, followed by interferon gamma and interleukin 8. In conclusion, an elevated Candida antigen titer in injured adults is associated with impaired polymorphonuclear leukocyte antifungal activity. This depressed activity can be reconstituted by the addition of cytokine.

(Arch Surg. 1993;128:40-46)

Author Affiliations
From the Departments of Surgery (Drs Sweeney and Rosemurgy) and Immunology and Medical Microbiology (Drs Wei and Djeu), University of South Florida College of Medicine, and the Immunology Program H. Lee Moffitt Cancer Center (Drs Wei and Djeu), Tampa, Fla.

Footnotes
Accepted for publication July 25, 1992.

Read before the 12th Annual Meeting of the Surgical Infection Society, Los Angeles, Calif, April 10, 1992.

Reprint requests to the Harbourside Medical Tower, Suite 730, 4 Columbia Dr, Tampa, FL 33606 (Dr Rosemurgy).

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