Neutrophils: Function and Role in Sepsis Syndrome

Abstract

Neutrophils play a vital role in the body’s response to many infectious and in_ammatory diseases. Despite the bene~cial role of neutrophils in host defense, these cells may also play an important role in the initiation and perpetuation of tissue injury through participation in the systemic in_ammatory response syndrome (SIRS). This massive and often imbalanced in_ammatory response can be seen in association with a large number of clinical conditions, such as, infections, pancreatitis, ischemia, burns, and trauma [1]. Many of the clinical manifestations and physiologic abnormalities that occur in this systemic in_ammatory reaction are attributed to the release of oxygen radicals and enzymes from neutrophils [2,3]. In this article we review normal neutrophil physiology, as well as the neutrophil changes in sepsis. We then examine the protective versus the pathogenic role of neutrophils in the septic shock syndrome as well as possible therapeutic modalities to modify neutrophil function in sepsis. Finally, we consider whether measurement of neutrophil activation in patients with presumed sepsis is of diagnostic or prognostic signi~cance.