• Nikola Grzalja, Tedi Cicvaric, Danijel Knezevic, Janja Kuharic, Alan Sustic, Bore Bakota, Simona Komen, and Tokmadzic Vlatka Sotosek VS Department of Anaesthesiology, Reanimatology and Intensive Care, Medical Faculty, University of Rijeka, Brace Branchetta 20, 51 000 Rijeka, Cr.
• Department ohhhhf Surgery, Medical Faculty, University of Rijeka, Brace Branchetta 20, 51 000 Rijeka, Croatia.
• Injury. 2017 Nov 1; 48 Suppl 5: S1-S7.

IntroductionTrauma with multiple injuries is associated with a high risk of complications, which may be related to excessive stimulation of inflammatory and anti-inflammatory responses. Although the effects of polytrauma on the immune response have been well established at the cellular and molecular levels, there is little information about the changes in the cytolytic potential of immunocompetent cells, including expression of cytotoxic molecules such as perforin. Therefore, the objective of the present study was to analyse and compare differences in the frequency and perforin expression of leukocyte subpopulations in the peripheral blood of patients with lower limb fracture, thoracic injury, and simultaneous lower limb fracture and thoracic injury.Patients And MethodsForty-five patients with trauma injury (15 patients with lower limb injury, 15 patients with thoracic injury, and 15 patients with simultaneous lower limb and thoracic injury) were included in the study. Peripheral blood of 15 sex- and age-matched healthy volunteers served as the control group. Peripheral blood samples were taken from all subjects included in the study and peripheral blood mononuclear cells were isolated by gradient centrifugation. The frequency of T lymphocytes, natural killer (NK) and NK T cells, and their subsets, as well as their perforin expression levels were simultaneously detected and analysed by flow cytometry.ResultsThere was a statistically significant decrease in the frequency of T lymphocytes, NK and NK T cells as well as perforin expression in the patients with simultaneous lower limb and thoracic injury compared with the other two groups, with a predominantly marked decrease in NK and NK T cells.ConclusionThe decrease in the frequency and cytotoxic potential of peripheral blood lymphocytes is related to the severity of trauma injury, which can explain the underlying mechanism contributing to complication occurrence.© 2017 Elsevier Ltd. All rights reserved.

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