Improvement of leukocyte bactericidal activity in chronic granulomatous disease.

C HRONIC GRANULOMATOUS DISEASE (CCD) is a genetic disorder characterized by chronic and recurrent pyogenic infections, with abscess and granuloma formation throughout the reticuloendothelial system. Patients’ leukocytes fail to demonstrate the increase in oxygen consumption, hexose monophosphate shunt activity, nitroblue tetrazolium reduction, and hydrogen peroxide formation which normally occur during phagocytosis.1’2 These oxidative defects have been ascribed to a deficiency of leukocyte DPNH ( NADH) oxidase activity.1’3 Phagocytes from patients with CGD can ingest bacteria normally, but can kill only those bacteria which effectively produce hydrogen peroxide, such as streptococci and lactobacilli.4’5 Bacteria which are not effective peroxide producers, such as staphylococci and serratiae, are not killed by these phagocytes.6 Klebanoff has shown that hydrogen peroxide combined with halides and myeloperoxidase constitute a potent bactericidal system,7 and that this system is lacking in CGD leukocytes.5 \Ve have previously reported marked improvement in intracellular formate oxidation and hexose monophosphate shunt activity by CGD leukocytes following the introduction of a hydrogen peroxideproducing system into these cells.8 This report describes the improved killing of ingested Staphylococcus aureus and Serratia marcescens achieved by this technique.