Humoral-Phagocyte Axis of Immune Defense in Burn Patients: Chemoluminigenic Probing

Both serum opsonic capacity and granulocyte oxygenation activity were measured in 35 burn patients during their course of therapy. The microbicidal action of granulocytes is effected via the metabolic generation of oxygenating agents; introduction of chemoluminigenic substrates, such as luminol or dimethyl biacridinium dinitrate, allows ultrasensitive measurement of phagocyte oxygenation activity. Serum opsonic capacity can also be assayed by measuring the rate of activation of phagocyte oxygenation activity. Alterations in granulocyte oxygenation activity were observed in individual patients in temporal association with changes in clinical condition, and sepsis was associated with a marked decrease in activity. An initial depression in opsonic capacity was noted at the time of admission of patients with major burns, more than 40% total body surface. Thereafter, depression of opsonic capacity was temporally associated with sepsis in individual patients. Chemoluminigenic probing provides a rapid, sensitive, and objective method for assessing the status of the humoral-phagocyte axis, and as a clinical laboratory technique is particularly applicable for monitoring patient populations in which sepsis is prevalent.