Bactericidal Activity Of Polymorphonuclear Leukocytes Research Articles

Inhibition of Peroxiredoxin 6 PLA2 Activity Decreases Oxidative Stress and the Severity of Acute Lung Injury in the Mouse Cecal Ligation and Puncture Model

The use of agents to inhibit the production of reactive oxygen species (ROS) has been proposed for the treatment of Acute Lung Injury (ALI). However, this approach also inhibits the bactericidal activity of polymorphonuclear leucocytes (PMN) and other cells, raising the possibility of aggravating lung injury in ALI associated with bacterial infection. We used the cecal ligation and puncture (CLP) model of ALI associated with sepsis to investigate the effect of inhibiting NADPH oxidase 2 (NOX2)-derived ROS production, the main source of ROS in lungs. A phospholipase A2 inhibitor called peroxiredoxin 6 inhibitory peptide-2 (PIP-2) was used to inhibit NOX2 activation; the peptide prevents liberation of Rac, a necessary NOX2 co-factor. At 18 h after intravenous treatment with 2 µg PIP-2 /gram body weight (wt), the number of colony-forming bacteria in lungs and peritoneal fluid of mice with CLP was approximately doubled as compared to untreated mice. Treatment with 10 µg PIP-2/g body wt resulted in 100% mortality within 18 h. Antibiotic treatment abolished both the increase in lung bacteria with low dose PIP-2 and the increased mortality with high dose PIP-2. Treatment with PIP-2 plus antibiotics resulted in significantly improved lung histology, decreased PMN infiltration, decreased lung fluid accumulation, and decreased oxidative lung injury compared to antibiotics alone. We conclude that the administration of PIP-2 provides partial protection against lung injury in a model of ALI due to bacterial infection, while concurrent antibiotic treatment abolishes the deleterious effects of PIP-2 on lung bacterial clearance. These results suggest that addition of PIP-2 to the antibiotic regimen is beneficial for treatment of ALI associated with bacterial infection.

Pathogenic Effect of Prevotella intermedia on a Mouse Pneumonia Model Due to Methicillin-Resistant Staphylococcus aureus With Up-Regulated α-Hemolysin Expression.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a common causative agent of pneumonia; however, the detailed mechanism underlying severe MRSA pneumonia, including association with oral hygiene or periodontitis, remains poorly characterized. In this study, we examined the pathogenic effect of Prevotella intermedia, a major periodontopathic pathogen, on MRSA pneumonia.Methods: The pathogenic effect of the supernatant of P. intermedia (Pi Sup) was investigated in a murine MRSA pneumonia model, using several clinical strains; whereas the bactericidal activity of polymorphonuclear leukocytes (PMNs) was investigated in vitro. The effect of Pi Sup on messenger RNA (mRNA) expression of the toxin/quorum sensing system (rnaIII) was investigated by quantitative reverse transcription PCR both in vitro and in vivo.Results: Mice infected by hospital-acquired MRSA (HA-MRSA) with Pi Sup exhibited a significantly lower survival rate, higher bacterial loads in the lungs, and higher α-hemolysin (hla) expression in the lungs, than those without Pi Sup. A similar effect of Pi Sup was not observed with MRSA strains producing Panton-Valentine leucocidin (PVL) or toxic shock syndrome toxin (TSST). In vitro, Pi Sup suppressed bactericidal activity of PMNs against the HA-MRSA strain. HA-MRSA was the clinical strain with the highest ability to proliferate in the lungs and was accompanied by time-dependent up-regulation of rnaIII and hla.Conclusions: Our results provide novel evidence that the product of P. intermedia exerts a pathogenic effect on MRSA pneumonia, in particular with a strain exhibiting strong proliferation in the lower airway tract. Moreover, our results indicate that P. intermedia affects MRSA toxin expression via quorum sensing in a strain-dependent fashion, which might be important for understanding the pathogenesis of severe MRSA pneumonia.

Dendritic Cell Dysfunction in Patients with End-stage Renal Disease.

End-stage renal disease (ESRD) with immune disorder involves complex interactions between the innate and adaptive immune responses. ESRD is associated with various alterations in immune function such as a reduction in polymorphonuclear leukocyte bactericidal activity, a suppression of lymphocyte proliferative response to stimuli, and a malfunction of cell-mediated immunity at the molecular level. ESRD also increases patients' propensity for infections and malignancies as well as causing a diminished response to vaccination. Several factors influence the immunodeficiency in patients with ESRD, including uremic toxins, malnutrition, chronic inflammation, and the therapeutic dialysis modality. The alteration of T-cell function in ESRD has been considered to be a major factor underlying the impaired adaptive cellular immunity in these patients. However, cumulative evidence has suggested that the immune defect in ESRD can be caused by an Ag-presenting dendritic cell (DC) dysfunction in addition to a T-cell defect. It has been reported that ESRD has a deleterious effect on DCs both in terms of their number and function, although the precise mechanism by which DC function becomes altered in these patients is unclear. In this review, we discuss the effects of ESRD on the number and function of DCs and propose a possible molecular mechanism for DC dysfunction. We also address therapeutic approaches to improve immune function by optimally activating DCs in patients with ESRD.

Garlic blocks quorum sensing and promotes rapid clearing of pulmonary Pseudomonas aeruginosa infections

The opportunistic human pathogen Pseudomonas aeruginosa is the predominant micro-organism of chronic lung infections in cystic fibrosis patients. P. aeruginosa colonizes the lungs by forming biofilm microcolonies throughout the lung. Quorum sensing (QS) renders the biofilm bacteria highly tolerant to otherwise lethal doses of antibiotics, and protects against the bactericidal activity of polymorphonuclear leukocytes (PMNs). It has been previously demonstrated that QS is inhibited by garlic extract. In this study, the synergistic effects of garlic and tobramycin, and PMNs activities have been evaluated. P. aeruginosa was grown in vitro in continuous-culture once-through flow chambers with and without garlic extract. The garlic-treated biofilms were susceptible to both tobramycin and PMN grazing. Furthermore, the PMNs showed an increase in respiratory burst activation, when incubated with the garlic-treated biofilm. Garlic extract was administered as treatment for a mouse pulmonary infection model. Mice were treated with garlic extract or placebo for 7 days, with the initial 2 days being prophylactic before P. aeruginosa was instilled in the left lung of the mice. Bacteriology, mortality, histopathology and cytokine production were used as indicators. The garlic treatment initially provoked a higher degree of inflammation, and significantly improved clearing of the infecting bacteria. The results indicate that a QS-inhibitory extract of garlic renders P. aeruginosa sensitive to tobramycin, respiratory burst and phagocytosis by PMNs, as well as leading to an improved outcome of pulmonary infections.

Pseudomonas aeruginosa tolerance to tobramycin, hydrogen peroxide and polymorphonuclear leukocytes is quorum-sensing dependent

The opportunistic human pathogen Pseudomonas aeruginosa is the predominant micro-organism of chronic lung infections in cystic fibrosis (CF) patients. P. aeruginosa colonizes the CF lungs by forming biofilm structures in the alveoli. In the biofilm mode of growth the bacteria are highly tolerant to otherwise lethal doses of antibiotics and are protected from bactericidal activity of polymorphonuclear leukocytes (PMNs). P. aeruginosa controls the expression of many of its virulence factors by means of a cell-cell communication system termed quorum sensing (QS). In the present report it is demonstrated that biofilm bacteria in which QS is blocked either by mutation or by administration of QS inhibitory drugs are sensitive to treatment with tobramycin and H2O2, and are readily phagocytosed by PMNs, in contrast to bacteria with functional QS systems. In contrast to the wild-type, QS-deficient biofilms led to an immediate respiratory-burst activation of the PMNs in vitro. In vivo QS-deficient mutants provoked a higher degree of inflammation. It is suggested that quorum signals and QS-inhibitory drugs play direct and opposite roles in this process. Consequently, the faster and highly efficient clearance of QS-deficient bacteria in vivo is probably a two-sided phenomenon: down regulation of virulence and activation of the innate immune system. These data also suggest that a combination of the action of PMNs and QS inhibitors along with conventional antibiotics would eliminate the biofilm-forming bacteria before a chronic infection is established.

Suppression of pathogenicity of Porphyromonas gingivalis by newly developed gingipain inhibitors.

Arg-gingipain (Rgp) and Lys-gingipain (Kgp) are cysteine proteinases produced by Porphyromonas gingivalis, a major etiological bacterium of periodontal diseases. Here we show a series of small peptide analogs able to inhibit either Rgp or Kgp, which are synthesized on the basis of the cleavage site specificity of human salivary histatins by each enzyme. Among this series of compounds, carbobenzoxy-Lys-Arg-CO-Lys-N-(CH2)2 (KYT-1) and carbobenzoxy-Glu(NHN(CH3)Ph)-Lys-CO-NHCH2Ph (KYT-36) were found to be the most potent inhibitors of Rgp and Kgp, respectively, with Ki values of 10(-11) to 10(-10) M order. Both inhibitors exhibited slight or no inhibition on mammalian proteinases such as trypsin and cathepsins B, L, and H. All of the virulence induced by the culture supernatant of P. gingivalis tested, including the degradation of various host proteins such as human type I collagen, immunoglobulins, fibronectin, and fibrinogen, disruption of the bactericidal activity of polymorphonuclear leukocytes, and enhancement of the vascular permeability, were strongly inhibited by a combined action of both inhibitors. The functions essential for the bacterium to grow and survive in the periodontal pocket, such as coaggregation and acquisition of amino acids, were also strongly inhibited by the combined action of both inhibitors. The disruption of the adhesion and viability of human fibroblasts and hemagglutination by the organism were strongly suppressed by a single use of KYT-1. These results thus indicate that the newly developed KYT-1 and KYT-36 both should provide a broader application in studies of this important class of enzymes and facilitate the development of new approaches to periodontal diseases.

Isolation and characterization of a novel and potent inhibitor of Arg-gingipain from Streptomyces sp. strain FA-70.

Arg-gingipain (Rgp) is a major cysteine proteinase produced by the oral bacterium Porphyromonas gingivalis, which is a major pathogen of advanced periodontal diseases. This enzyme is important for the bacterium both to exhibit its virulence and to survive in periodontal pockets. The development of Rgp inhibitors thus provides new therapeutic approaches to periodontal diseases. In this study, we first isolated and purified a novel and potent inhibitor of Rgp from the culture supernatant of Streptomyces species strain FA-70, now designated as FA-70C1. This compound was found to be an antipain analog composed of phenylalanyl-ureido-citrullinyl-valinyl-cycloarginal (C27H43N9O7). The Ki value was calculated to be 4.5x10(-9) M when benzyloxycarbonyl-phenylalanyl-arginine-4-methly-coumaryl-7-amide was used as a substrate. This compound also inhibited cathepsins B, L, and H, though their Ki values were much higher than that of Rgp. FA-70C1 had little or no inhibitory activity on Lys-gingipain, another cysteine proteinase of P. gingivalis. The Rgp-induced degradation of various human proteins was completely blocked by this inhibitor. Disruption of both the bactericidal activity of polymorphonuclear leukocytes and the viability of human fibroblasts and umbilical vein endothelial cells induced by the culture supernatant of P. gingivalis was suppressed by the inhibitor in a dose-dependent manner. The enhancement of vascular permeability induced by in vivo administration of the culture supernatant of P. gingivalis was strongly inhibited by the inhibitor. Furthermore, the growth of P. gingivalis was suppressed by FA-70C1 in a dose-dependent manner. These results strongly suggest that FA-70C1 is a useful tool to prevent the virulence of P. gingivalis.

Tumor necrosis factor-alpha-stimulated polymorphonuclear leukocytes suppress migration and bactericidal activity of polymorphonuclear leukocytes in a paracrine manner.

Polymorphonuclear leukocytes (PMN) and tumor necrosis factor-alpha (TNF-alpha) play prominent roles in acute respiratory distress syndrome, ischemia-reperfusion injury, trauma, and sepsis. Whereas direct effects of TNF-alpha on PMN function and viability are well documented, little data are available addressing the ability of PMN to communicate with each other in response to cytokine stimulation. Therefore, the aim of this study was to determine whether TNF-alpha can modulate PMN function by inducing PMN to secrete products upon stimulation, which would affect other PMN in vitro in a manner independent of cell contact. PMN were purified daily from blood obtained from a pool of 22 healthy volunteers. Conditioned media (CM-TNF) was prepared by incubating PMN in Hanks' balanced salt solution plus TNF-alpha for 1-4 hrs. Freshly isolated PMN were resuspended in CM-TNF and analyzed for 1) phagocytosis of opsonized Escherichia coli, 2) oxidative metabolism as measured as an index of DCF-DA activation, and 3) migration to chemoattractants through Transwell inserts. CM-TNF decreased PMN phagocytotic activity by 8% to 15% and completely suppressed oxidative metabolism but did not modulate the expression of receptors associated with these functions. CM-TNF suppressed the migration of PMN to two biologically relevant agents, N-formyl-methionyl-leucyl-phenylalanine and leukotriene B4, by approximately 65%, but had no effect on PMN migration to interleukin-8. This suppression was observed for migration across plastic filters as well as extracellular matrix proteins. Our data demonstrate that PMN stimulated with TNF-alpha suppress the immunologic function and migration of other PMN independent of cell-cell contact and suggest that TNF-alpha may participate in a negative feedback loop by inducing a PMN-derived factor that counteracts its activity.

Involvement of a Lysine-specific Cysteine Proteinase in Hemoglobin Adsorption and Heme Accumulation by Porphyromonas gingivalis

The oral anaerobic bacterium Porphyromonas gingivalis, a major pathogen of advanced adult periodontitis, produces a novel class of cysteine proteinases in both cell-associated and secretory forms. A lysine-specific cysteine proteinase (Lys-gingipain, KGP), as well as an arginine-specific cysteine proteinase (Arg-gingipain), is a major trypsin-like proteinase of the organism. Recent studies indicate that the secreted KGP is implicated in the destruction of periodontal tissue and the disruption of host defense mechanisms. In this study, we have constructed a KGP-deficient mutant to determine whether the cell-associated KGP is important for pathophysiology of the organism. Although the mutant retained the strong ability to disrupt the bactericidal activity of polymorphonuclear leukocytes, its hemagglutination activity was reduced to about one-half that observed with the wild-type strain. More important, the mutant did not form black-pigmented colonies on blood agar plates, indicating the defect of hemoglobin adsorption and heme accumulation. Immunoblot analysis showed that the expression of a 19-kDa hemoglobin receptor protein, which is thought to be responsible for hemoglobin binding by the organism, was greatly retarded in this mutant. The mutant also showed a marked decrease in the ability to degrade fibrinogen. These results suggest the possible involvement of KGP in the hemoglobin binding and heme accumulation of the organism and in the bleeding tendency in periodontal pockets.

Synergy of simultaneous administration of ofloxacin and granulocyte colony-stimulating factor in killing of Escherichia coli by human neutrophils.

The in vitro effect of subinhibitory and inhibitory concentrations of ofloxacin and G-CSF on the bactericidal activity of polymorphonuclear leucocytes (PMNL) against Escherichia coli was investigated. PMNL obtained from healthy volunteers were incubated with different concentrations of G-CSF and ofloxacin for 180 min. The minimum inhibitory concentration (MIC) of ofloxacin and even 1/4 x MIC enhanced the bactericidal activity of PMNL. G-CSF at a concentration of 6,000 units/ml led to a significant improvement of the bactericidal activity of PMNL. The combination of 6,000 units/ml of G-CSF and ofloxacin in inhibitory as well as subinhibitory concentrations, however, showed a significant synergistic effect on the antibacterial activity of PMNL during the complete incubation period. Combinations of G-CSF and antibiotics could therefore be beneficial for infected patients, especially those with impaired cellular host defense.

Combined effect of human neutrophils, ceftazidime and granulocyte colony-stimulating factor on killing ofEscherichia coli

The combination effect of subinhibitory and inhibitory concentrations of ceftazidime, granulocyte colony-stimulating factor (G-CSF) and polymorphonuclear leukocytes (PMNL) against Escherichia coli was investigated. PMNL obtained from healthy volunteers were incubated with different concentrations of G-CSF and ceftazidime for 180 min. The addition of 0.25 x MIC of ceftazidime or 1 x MIC significantly enhanced the bactericidal activity of PMNL. G-CSF at a concentration of 6,000 units/ml led to only a slight improvement in the bactericidal activity of PMNL. The combination of 6,000 units/ml G-CSF and ceftazidime in inhibitory as well as subinhibitory concentrations, however, showed a significant synergistic effect (p < 0.01) on the antibacterial activity of PMNL during the entire incubation period. Combinations of G-CSF and antibiotics could therefore be beneficial for infected patients, especially those with impaired cellular host defence.

Studies on periodontal pathogenic proteinases from Porphyromonas gingivalis and host cells

Progressive periodontal disease is characterized by acute progressive lesions of gingival connective tissues, excessive leukocyte infiltration, and occurrence of a characteristic microflora. A variety of proteolytic enzymes derived from oral bacteria and host cells are found in gingival crevices and thought to play an important role in the onset and development of progressive periodontal disease. The anaerobic bacterium Porphyromonas gingivalis has been implicated in the etiology of the disease. Recently, we have purified a novel arginine-specific cysteine proteinase, termed "argingipain", from the culture supernatant of the organism. The enzyme was shown to have two important abilities related to the virulence of the organism. One is direct association with periodontal tissue breakdown through its abilities to degrade physiologically important proteins such as human collagens (type I and IV) and to evade inactivation by internal protease inhibitors. The other is associated with disruption of the normal host defense mechanisms through its abilities to degrade immunoglobulins and to inhibit the bactericidal activity of polymorphonuclear leukocytes. The virulence of argingipain was further substantiated by disruption of argingipain-encoding genes on the chromosome by use of suicide plasmid systems. On the other hand, we have studied roles of host cell-derived proteinases in the periodontal tissue breakdown. Levels of lysosomal proteinases such as cathepsins B, H, L, G and medullasin were determined in gingival crevicular fluid from periodontitis patients and experimental gingivitis subjects by activity measurement and sensitive immunoassay. The results suggested that all of these enzymes would be involved in the development of both gingivitis and periodontitis.

The effect of burn wound surgery and teicoplanin on the bactericidal activity of polymorphonuclear leucocytes against Staphylococcus aureus.

Polymorphonuclear leucocyte (PMN) function is suppressed for several weeks after burn injury, rendering patients susceptible to infection, commonly with Staphylococcus aureus. A study was performed to determine the effects of surgery to the burn wound and antimicrobial prophylaxis with teicoplanin on killing of S. aureus by PMNs taken from burn patients. The bactericidal rate was significantly reduced before surgery compared to controls (P < 0.01 Mann Whitney), but neither surgery nor teicoplanin had any significant additional effect on the bactericidal rate. The bactericidal rate of PMNs did not have any significant effect on clinical outcome following surgery.

Stimulation of the bactericidal activity of polymorphonuclear leukocytes by manganese.

An antioxidant effect of manganese (Mn) complexes due to the scavenging of the superoxide anion (O2-.) or to the decomposition of hydrogen peroxide (H2O2) has been described. We report here that Mn also can exert a prooxidant effect under certain experimental conditions. Thus Mn2+ in phosphate buffer increased the bactericidal effect of phorbol myristate acetate-stimulated polymorphonuclear leukocytes (PMNs) on extracellular Escherichia coli. This effect was inhibited by azide, catalase, and a decrease in chloride concentration and was not observed when normal PMNs were replaced by those of patients with chronic granulomatous disease or myeloperoxidase (MPO) deficiency. Mn2+ could be replaced by Mn3+ or by superoxide dismutase (SOD). These findings suggest that Mn (or SOD), by increasing the conversion of O2-. to H2O2, can increase the activity of the MPO-H2O2-chloride antimicrobial system released by stimulated PMNs.

Suppression of polymorphonuclear leukocyte bactericidal activity by suramin.

Suramin is a polyanionic compound with potent antineoplastic properties. Because polymorphonuclear leukocytes (PMNs) are a crucial component of host defenses against bacteria and fungi, the effects of suramin on PMN function were studied in vitro. PMNs from healthy donors were incubated with concentrations of suramin of 1 to 1,000 micrograms/ml (within and exceeding the therapeutic range) for 30 min, and PMN functional parameters were subsequently assessed. Suramin had no effect on viability, chemotaxis to N-formylmethionyl leucyl phenylalanine, phagocytosis of Candida albicans, or superoxide anion production in response to phorbol myristate acetate and formylmethionyl leucyl phenylalanine. Fungicidal activity against C. albicans blastoconidia was unaffected at a suramin concentration of < 500 micrograms/ml, whereas at higher concentrations a slight suppression was observed (P = 0.04). Bactericidal activity against Staphylococcus aureus was significantly suppressed by concentrations of > or = 100 micrograms/ml (P < 0.01). Phagocytosis of S. aureus was also significantly impaired at > or = 10 micrograms/ml (P < 0.05). The presence of 10% human serum during pretreatment did not abrogate the suramin-induced suppression of bactericidal activity. Treatment of PMNs with granulocyte colony-stimulating factor (4,000 U/ml) for 30 min prior to the addition of suramin (250 micrograms/ml) improved the bactericidal defect (P = 0.02). The PMN functional impairment may be related to increased susceptibility to bacterial infections, and granulocyte colony-stimulating factor may improve the defect.

Enhancement of in vitro bactericidal activity of neutrophils from trauma patients in the presence of granulocyte colony-stimulating factor.

In order to determine whether granulocyte colony-stimulating factor (G-CSF) can enhance the bactericidal activity of polymorphonuclear leukocytes (PMNL) in trauma patients, PMNL obtained from severely injured patients one or two days after trauma were incubated with G-CSF and Staphylococcus aureus for different periods of time. G-CSF at a concentration of 6000 units/ml significantly improved the antibacterial activity of PMNL in trauma patients (n = 10) and healthy volunteers (n = 12) during the incubation period of 180 min. No difference in the bactericidal function of PMNL could be found between severely injured patients and healthy donors.

Cooperative complement- and bacterial lectin-initiated bactericidal activity of polymorphonuclear leukocytes

The recognition of glycoconjugate receptors on sialidase-treated polymorphonuclear leukocytes (PMNs) by the Gal/GalNAc-reactive fimbrial lectin of Actinomyces viscosus T14V has previously been shown to initiate lactose-inhibitable phagocytosis and subsequent killing of the bacteria. Although a mutant lacking fimbriae, A. viscosus 147, was not destroyed by this mechanism, the present studies demonstrate that the deposition of C3 fragments on this bacterium by anti-A. viscosus 147 immunoglobulin M (IgM) prior to incubation with either untreated or sialidase-treated PMNs correlated with a reduction in viability of approximately 2 log10. This bactericidal activity was unaffected by lactose. A similar decrease in viability was observed following the addition of untreated PMNs to A. viscosus T14V preincubated with anti-A. viscosus 147 IgM and complement, conditions favorable for C3- but not lectin-mediated bactericidal activity. Neither IgM nor complement alone was opsonic for either strain, and individually they did not alter killing of A. viscosus T14V by sialidase-treated PMNs or inhibition of this bactericidal activity by lactose. The number of viable A. viscosus T14V cells was decreased by approximately 3.5 log10 when the bacteria were incubated with IgM and complement prior to the addition of sialidase-treated PMNs, and lactose only partially inhibited this response. Thus, the PMN-dependent bactericidal activity initiated by the participation of both the actinomyces lectin and complement was significantly greater than that achieved by either ligand alone.

Iron and Immunity

Review of animal and human studies concerning the impact of iron deficiency on immune function in vivo indicates that in many instances there is no firm consensus of opinion as to the relationship between iron status and immunity. One major problem with almost all human studies is that other micro- and macronutrient deficiencies are inadequately controlled for and thus it is often unclear as to whether reported abnormalities of immune function can be attributed specifically to iron deficiency. Even when abnormalities of immune function have been detected it is often uncertain as to the biological and clinical relevance that these may have for the host. Within these restraints the available studies suggest that iron deficiency may at least contribute to impaired T lymphocyte function as judged by DTH responses in skin and impaired mitogen-induced proliferation. As in protein energy malnutrition, humoral immunity is largely spared in humans, the balance of evidence suggesting that immunoglobulin production and function is normal, as are serum concentrations of complement. The only other abnormality of non-specific immunity which has been reported consistently to be abnormal is that of reduced bactericidal activity of polymorphonuclear leucocytes. The clinical relevance of these abnormalities remains to be established. There is, however, no evidence to suggest that individuals with iron deficiency suffer the devastating infective complications of the well defined immunodeficiency syndromes either congenital or acquired. It seems likely therefore that despite the fundamental importance of iron in maintaining the integrity of immune function, humans can tolerate the extremes of deficiency and excess and survive in a relatively healthy state.

Phagocyte Metabolic Functions in Iron Deficiency Anaemia of Indian Children

Nitroblue tetrazolium test (NBT) and bactericidal activity of polymorphonuclear leucocytes was studied in 40 patients with iron deficiency anaemia (aged 0-12 years). NBT test had a significant correlation with serum iron (P less than 0.001) in all cases of iron deficiency anemia. Haemoglobin levels less than 4 g/dl also correlated significantly with NBT score. Bactericidal activity with opsonin-coated Staphylococcus aureus was considerably decreased in severe anaemia, but no significant correlation was found with serum iron concentration (P less than 0.1). The phagocytic and bactericidal activity of polymorphonuclear leucocytes is dependent upon serum iron levels and is considerably reduced in iron deficient state in anaemic children.

Nonsteroidal Anti-Inflammatory Drugs Correct the Bactericidal Defect of Polymorphonuclear Leukocytes in a Guinea Pig Model of Thermal Injury

We conducted studies to determine the effects of parenteral therapy with indomethacin, ibuprofen, and piroxicam on key immunologic and hematologic alterations induced by thermal injury. Drugs (10-20 mg/kg) or placebo were administered intramuscularly to thermally injured guinea pigs at 3 h postburn and then daily for nine days postburn. All three drugs inhibited production of 6-keto prostaglandin F1 alpha and thromboxane B2 in wound fluid and concomitantly restored the bactericidal activity of polymorphonuclear leukocytes (PMNLs) against Pseudomonas aeruginosa to normal. Indomethacin also increased the proliferative response of splenic lymphocytes to concanavalin A; however, ibuprofen and piroxicam had no effect on this response. None of the drugs affected the extent of systemic complement consumption, thrombocytopenia, leukocytosis, or leukopenia in the injured animals. These results suggest that the PMNL bactericidal defect induced by thermal injury is preventable or reversible and that the mechanisms responsible for this defect are inhibitable by nonsteroidal anti-inflammatory drugs.