Polymorphonuclear Leukocyte Dysregulation During the Systemic Inflammatory Response Syndrome

Altered polymorphonuclear leukocyte (PMN) function is thought to contribute to organ dysfunction during the systemic inflammatory response syndrome (SIRS). To test this hypothesis, we evaluated whole blood PMN function adherent to fibronectin or laminin in patients with mild or severe acute pancreatitis as a paradigm for sirs. Whole-blood PMN intracellular HzOZ production, expression of CD32w (FcrR H), CD16 (Fc-yR Ill), and phagocytosis were performed using dichlorofluorescein diacetate, fluorescein isothiocyanate-labeled anti-CDBZw, CD1 6, and senrm-opsonized fluorescent microspheres. Group I (n X 7 ) represents normal control individuals; group II (n X 1 1 ) represents patients with mild acute pancreatitis. Group 111 (n X 15) represents critically ill patients with severe acute pancreatitis. Adherence of PMN from groups I and II to matrix proteins resulted in a 5% to 20% increase in each PMN function assayed whereas adherence of PMN from group 111 to matrix proteins resulted in 50% to 75% increases in each PMN function assayed. Pertussis toxin, pentoxifylline, and dibu-