Selectins in multiple injured patients with severe head trauma

cc16 CCJ Meeting abstract Selectins in multiple injured patients with severe head trauma Kerner T Höfler S Keh D Spielmann S Gerlach M Falke K Adams HP Gerlach H

Clinic of Anesthesiology and Intensive Care Medicine, Virchow-Klinikum, Humboldt University of Berlin, Germany

Critical Care 17th International Symposium on Intensive Care and Emergency Medicine Meeting abstracts 17th International Symposium on Intensive Care and Emergency Medicine Brussels, Belgium

18–21 March 1997

1364-8535 1997 1 Suppl 1 P010 10.1186/cc16 1 3 1997 1997 Current Science Ltd cc-1-1-p010

High mortality rates days or weeks after multiple injury are often due to multiple organ dysfunction (MODS). Recent studies put a close view to the course of immunological mediators as the members of the selectin family to figure out their contribution to shock, sepsis and organ failure [1]. Brain contusion is supposed to cause cellular infiltrates and inflammation in brain tissue [2].

P-selectin (CD62P) is stored in endothelial cells (EC) Wiebel-Palade-bodies and in thrombocytes. It is rapidly released after cell activation. E-selectin (CD62E) is expressed on the cell surface of EC and shed from there after IL-1/TNF stimulation. L-selectin (CD62L) can be found on the surface of leukocytes. Cell activation leads to shed L-selectin by proteolytic processes [3].

We examined soluble E- and P-selectin and L-selectin on B-lymphocytes in multiple injured patients without or with moderate or with severe head injury. The classification of head injury was performed following the injury severity score (ISS) (0-2 pts, moderate; 3-5 pts, severe head injury).

sE-, P- and L-selectin were- measured in 51 multiple injured patients with samples taken on 10 time points (from the location of the accident = 0 h to the 6th post-traumatic day = 144 h) by using commercially available standardized enzyme-linked immunoassays (ELISA). CD62L levels on leukocyte subpopulations were detected using the monoclonal antibodies CD62L (LECAM-1), CD3 (T-cell), CD19 (B-cell), CD14 (monocyte) and a standard flow cytometer.

Table 1 demonstrates the very early increase of sP-selectin in patients with severe head injury (P = 0.0001) compared to those with moderate or no head injury.

Table 2 illustrates the later increase (P = 0.0026) of sL-selectin levels (72 h) in severe head injured individuals while L-selectin on CD19+ B-lymphocytes is expressed significantly stronger (P = 0.0001) in the very early post-traumatic phase (0-24 h) = Table 3.

The gravity of head trauma seems to influence the immunological response and subsequently the cell-cell interactions.

Table 1

Table 2

Table 3

Acknowledgement

Supported by the BMVg, Grant InSan 1 0993-V-1296.

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