Natural Killer T Cells Are Numerically and Functionally Deficient in Patients with Trauma

Natural killer T (NKT) cells rapidly produce Th1 and Th2 cytokines such as interferon-gamma (IFN-gamma) and interleukin (IL)-4. This study examined the frequency and function of NKT cells in trauma patients. Frequencies, proliferative responses to alpha-galactosylceramide (alpha-GalCer), and Th1/Th2 cytokine secretion levels of NKT cells in peripheral blood mononuclear cells from trauma patients and healthy controls (HC) were measured by flow cytometry. Circulating NKT cell levels were significantly reduced in trauma patients. Proliferation and IFN-gamma production of circulating NKT cells in response to alpha-GalCer were markedly decreased in trauma patients. CD69 expression levels produced by NKT cells were significantly upregulated in trauma patients compared to those in HC. In addition, annexin V+ NKT cells were profoundly increased in trauma patients after alpha-GalCer stimulation. Trauma patients had higher plasma levels of IL-6, IL-8, and TNF-alpha compared to HC. In particular, the proliferative response of NKT cells to alpha-GalCer was significantly decreased in the presence of these cytokines. Such decrease was partially recovered after treatment with blocking antibodies against these cytokines. This study demonstrates that circulating NKT cells are numerically deficient and functionally impaired in IFN-gamma production in trauma patients. These findings provide an important insight into the trauma-related innate immune response.