Enhancement of natural killer cell activity in septic shock patients by a mixture of the calcium ionophore A23187 and the phorbol ester TPA: in vitro studies

Preincubation of peripheral blood lymphocytes from drug-free, healthy volunteers with a mixture of the calcium ionophore A23187 (Io) and the phorbol ester TPA (12-O-tetradecanoylphorbol-13-acetate) consistently resulted in a significant enhancement (dose-dependent; maximum immunostimulation obtained with the Io + TPA final mixture concentration of 10 uM + 250 ng/ml, respectively) of natural killer cell activity (NKCA) (n = 8; mean +/- SD of 16.8 +/- 8.9 and 52.0 +/- 18.0, paired Student's t-test p < 0.005; effector-to-target cell ratio of 30:1). Results from the same protocol, but using samples from septic shock patients followed a similar trend; however, and perhaps reflecting the significantly lower baseline NKCA in this group of individuals (n = 7), the mean value reached for this cellular immune function after incubation with Io + TPA was significantly lower than that of the treated controls' group (mean +/- SD of 19.8 +/- 11.6 and 52.0 +/- 18.0, respectively, Student's t-test p < 0.005). As expected from the role of calcium in the activation of NKCA, incubation with the Io significantly increased baseline NKCA, which was largely unchanged by TPA. Expression of the CD56+ and CD16+ phenotypes in septic shock patients did not correlate directly with NKCA, suggesting that this condition may be associated with changes in the function rather than the quantity of these cellular markers.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro studies of natural killer cell activity in septic shock patients. Response to a challenge with alpha-interferon and interleukin-2

Natural killer cell activity (NKCA) in patients with septic shock was statistically significantly lower than the value recorded for a group of drug-free, healthy volunteers [9.1 +/- 7.8 (n = 20) and 20.6 +/- 16.6 (n = 15), respectively; Student's test, p < 0.05]. As expected, preincubation of peripheral blood lymphocytes from samples taken from a group of controls with either alpha-interferon or interleukin -2 resulted in an enhancement of NKCA for each and everyone of the subjects studied; however, results from a similar protocol using patient samples showed a lack of consistency, both in the direction and magnitude, in the elicited changes in NK lytic function. Whereas samples from same patient responded with either an increase or a decrease in NKCA to preincubation with both immunostimulators, others responded with NKCA upmodulation to one and downmodulation to other of these test substances. A better knowledge of the mechanism(s) responsible for the depressed expression of NKCA in septic shock patients, and its altered response to alpha-interferon and interleukin-2, could generate new modalities in the diagnosis and therapy of this condition.