Immunologische Risikostratifizierung bei Osteitistherapie

Abstract

The treatment of osteomyelitis is a challenging problem. Due to the fact that the treatment frequently leads to serious consequences for the patient we would like to have a tool that may lead to a pre-therapeutic risk assessment in order to create an improved, more individual therapy. The analysis of specific immune parameters (double negative T-cells) seems to be a promising step in this direction. In addition to the pilot study from 2011 another 22 patients with a prolonged course of the disease leading to limb amputation were included in this study. The double negative T-cells were analysed at an average of 3.4 years after the end of the treatment by flow cytometry. There were no clinical and laboratory signs of infection. The results were compared to an age-matched control group of healthy probands. The analysis of the double negative T-cells by flow cytometry showed conformity with the results of our pilot study. At the cut-off level of 60 DNT/μl the results of the 22 patients with prolonged course of the disease could be distinguished distinctly from those of the control group. The immunological deficit was detectable retrospectively even after the end of therapy. This may lead to the assumption that there may exist a permanent immunological alteration in those patients. © Springer-Verlag 2012.