Translocation of bacterial NOD2 agonist and its link with inflammation
Translocation of bacterial NOD2 agonist and its link with inflammation
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DOI：
10.1186/cc7980
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发表时间：
2009-01-01
期刊：
影响因子：
15.1
通讯作者：
Adib-Conquy, Minou
中科院分区：
文献类型：
--
作者：
Kim, Oh Yoen;Monsel, Antoine;Adib-Conquy, Minou
前言肠道通常被认为是危重疾病的发动机，通过细菌移位，放大炎症反应并改变免疫状态。然而，系统性细菌移位很少得到证实，内毒素测量仅反映革兰氏阴性衍生产物的移位。该过程可以更频繁地确定，如果肽聚糖，来自革兰氏阴性和革兰氏阳性bacteries.Methods，我们开发了一种新的工具来检测循环肽聚糖样结构使用NOD 2转染的细胞系。我们还测量了血浆和细胞相关的内毒素和不同的血浆炎症标志物。我们研究了21例接受腹主动脉手术（AAS）的患者，21例接受颈动脉手术（CAS）的患者作为阴性对照。患者在手术过程中采样，直到两天post-surgery.Results在90.5%的AAS患者，NOD 2激动剂峰检测到血浆中主动脉阻断前，但由外科医生肠道操作后，并持续血液再灌注后。正如预期，在CAS患者的血浆中未检测到峰（P = 0.003）。71%的AAS患者在血液再灌注后出现白细胞结合内毒素，其中57%的患者检测到循环内毒素。白细胞介素（IL）-6，IL-10和炎症标志物（C-反应蛋白，降钙素原）的水平在术后第1天或第2天的AAS患者最高。NOD 2激动剂水平与皮质醇、IL-10水平呈正相关。结论NOD 2激动剂水平的测定比内毒素水平的测定更能早期、敏感地检测细菌产物的移位。数据表明，循环NOD 2激动剂有助于进一步增强手术后的应激反应。
Introduction The gut is often considered as the motor of critical illness through bacterial translocation, which amplifies the inflammatory response and alters the immune status. However, systemic bacterial translocation was rarely proven and endotoxin measurement only reflects translocation of Gram-negative-derived products. The process could be more frequently identified if peptidoglycan, derived from both Gram-negative and Gram-positive bacteria, was measured.Methods We developed a new tool to detect circulating peptidoglycan-like structure using a NOD2-transfected cell line. We also measured plasma and cell-associated endotoxin and different plasma markers of inflammation. We studied 21 patients undergoing abdominal aortic surgery (AAS), and 21 patients undergoing carotid artery surgery (CAS) were included as negative controls. Patients were sampled during surgery until two days post-surgery.Results In 90.5% of the AAS patients, a NOD2 agonist peak was detected in plasma before aortic clamping, but after gut manipulation by the surgeon, and persisted after blood reperfusion. As expected, no peak was detected in plasma from CAS patients (P = 0.003). Leukocyte-bound endotoxin appeared after blood reperfusion in 71% of the AAS patients, and circulating endotoxin was detected for 57% of them. The levels of interleukin (IL)-6, IL-10 and of inflammatory markers (C-reactive protein, procalcitonin) were maximal at postoperative day 1 or 2 in AAS patients. The levels of circulating NOD2 agonist positively correlated with those of cortisol and IL-10.Conclusions The measurement of circulating NOD2 agonist gives a higher informative tool than that of circulating endotoxin for early and sensitive detection of the translocation of bacterial products. The data suggest that circulating NOD2 agonist contributes to further enhance the stress response following surgery.