Polymorphonuclear neutrophilic leukocytes (PMNLs) play a key role in host defense, and phagocyte dysfunction has been associated with increased susceptibility to
infection in patients with thermal injury. We have used flow cytometric analysis (FCM) to longitudinally study PMNL expression of
IgG Fc-receptor II (
Fc gamma RII) and
Fc-receptor III (
Fc gamma RIII), as well as the
complement receptors CR1 (receptor for C3b) and
CR3 (receptor for
C3bi) in 22 patients with large
burns. Analyses of PMNL
complement and
immunoglobulin-mediated phagocytosis of Candida albicans were performed in parallel.
Burn patient PMNL
Fc gamma RIII expression was decreased to 58% of control values at admission, and remained low for the first 3 weeks. The expression of patient PMNL
Fc gamma RII was not altered at admission or throughout the
hospital stay. The CR1-dependent fluorescence was increased by 62% at admission, and reached a maximum at day 2, 138% greater than that of controls. The CR1 expression then gradually returned to normal at discharge. The PMNL CR3-dependent fluorescence showed an increase of 110% at admission and remained high during the first 3 weeks. The
immunoglobulin-mediated phagocytosis was decreased by 12% at admission, whereas the lowest value was observed at day 10, with a reduction of 30% compared with controls. The patient PMNL
complement-mediated phagocytosis of C. albicans was increased by about 160% at admission, and reached a maximum at day 2, before it gradually decreased to control levels at discharge. The expression of
complement receptors correlated positively, whereas the expression of
Fc gamma RIII correlated negatively, with total body surface area (TBSA)
burn.(ABSTRACT TRUNCATED AT 250 WORDS)