外傷急性期における好中球の形態変化

DOI 被引用文献1件 参考文献26件

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  • Morphological Changes in Neutrophils in the Early Stage of Trauma.

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Neutrophil leukocytes (NLs) are able to migrate and accumulate the damaged regions in the initial stage of inflammation. They are not only involved in phagocytosis of bacteria and degenerated cell debris, but, by releasing of various cytokines and enzymes, in the developmentof sepsis and MOF Recently, reports dealing with the expression and upregulation of epitopes of NLs in the acute stage of traumatic injury have been published by several investigators. However, little is known about the details of the morphological changes in NLs in this stage. In the present study, the authors collected blood from trauma patients and prepared smears at 30min, and 12, 24, and 48 hours after the injury. Smears were stained with Wright-Giemsa solution and by the PAS (periodic acid Schiff) method, for light microscopic observation. For electron microscopic examinatio, NLs were separated from heparinized blood as soon as possible striving to prevent morphological artifacts at the same interval. Immediately after separation by centrifugation at 800G to remove the plasma, the leukocyte layer was directly fixed with a mixture of 2.5% para and 2% glutaraldehyde solution and refixed with 1% osmic solution. After dehydration, the specimens were embedded in Epon812 and examined with a JEM2000EX electron microscope. The findings in the PAS-stained specimens and electron micrographs were analyzed with an image processing system. At the light microscopy level, the PAS stainability of NL was shown to decrease between 30min and 12 hours after the injury and to recovers at 48 hours. At the electron-microscopic level, cytosol opacity increased, glycogen granule opacity decreased, from 30min to 12 hours, and recovered at 48 hours. Thus, the contrast of NLs in electron micrographs decreases markedly in the initial stage and recovers at 48 hours. The mitochondria of NLs stand out at 12 and 24 hours, and the Golgi apparatus-especially its lamellar structure-increases in size and in electron opacity, and becomes discernible at 24 hours. Although there was some discrepancy between the observations and the results of image analysis, the sequential changes occurring NL progress in almost in the same pattern. The findings concerning the short life span of NLs reported here, seem to be closely associated with the milieu in peripheral blood, in which NLs circulate for several hours. Possibly, the milieu is affected by the concentration of endotoxin, cytokines, catecholamines, and hormones (endogenous and exogenous) in blood.

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