Lymphocyte subset responses to trauma and sepsis

J Trauma. 1993 Dec;35(6):844-9. doi: 10.1097/00005373-199312000-00007.


One hundred five trauma patients admitted to three trauma centers with injury Severity Scores of 20 or greater had lymphocyte phenotypic subsets characterized throughout their hospital course. Total lymphocytes, pan-T (CD2), helper T (CD4), suppressor T (CD8), pan B (CD20), and DR expressing lymphocytes were quantitated by monoclonal antibodies and flow cytometric analysis. Results were analyzed between three patient groups: uninfected, uneventful recovery (n = 64); major infection (n = 26); and dead (n = 15; 7 with sepsis). A significant lymphopenia, maximal at 3 days, occurred in the first postinjury week compared with controls (p < 0.05), which recovered over the study period. A hierarchical distribution was found between the three outcome groups with the lowest numbers of several lymphocyte phenotypes in those who died. T helper and suppressor cells were similarly affected, but lowest in patients destined to develop infection or die. The helper-suppressor ratio, however, was similar in all three outcome groups. Therefore, modulation early after injury aimed at restoring these subsets may reduce the risk of subsequent infection.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Antibodies, Monoclonal
  • Case-Control Studies
  • Female
  • Flow Cytometry
  • Humans
  • Immunophenotyping
  • Infections / etiology*
  • Infections / mortality
  • Injury Severity Score
  • Leukocyte Count
  • Lymphocyte Subsets*
  • Lymphopenia / blood*
  • Lymphopenia / etiology
  • Male
  • Middle Aged
  • Multiple Trauma / classification
  • Multiple Trauma / complications*
  • Multiple Trauma / mortality
  • Multiple Trauma / surgery
  • Predictive Value of Tests
  • Prognosis
  • Splenectomy
  • Survival Rate
  • Time Factors


  • Antibodies, Monoclonal