Heterogeneity among septic shock patients in a set of immunoregulatory markers.
Heterogeneity among septic shock patients in a set of immunoregulatory markers.
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DOI：
10.1007/s10096-013-1957-y
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发表时间：
2014-03
影响因子：
4.5
通讯作者：
Bredberg, A.
中科院分区：
文献类型：
--
作者：
Janols, H.;Wullt, M.;Bergenfelz, C.;Bjornsson, S.;Lickei, H.;Janciauskiene, S.;Leandersson, K.;Bredberg, A.
免疫激活是脓毒症的一个常见特征，但随后的炎症消退和免疫抑制成分的发生率及性质却不太为人所知。在这项研究中，我们比较了革兰阴性或革兰阳性脓毒症或脓毒性休克患者血液白细胞上的免疫调节标志物，并将其与重症病毒感染患者或健康对照者的血液进行了比较。为此，我们通过流式细胞术分析了32例脓毒症患者（包括10例休克患者）和12例重症病毒感染患者血液中单核细胞HLA - DR、CD11c、CD14和CD40的表达水平，以及CD163⁺抑制性单核细胞、HLA - DR⁺或CD40⁺活化T细胞和调节性T细胞（Tregs）的频率。同时分析血浆细胞因子水平作为一项功能性检测指标。免疫抑制的迹象在脓毒性休克和革兰阳性脓毒症组中占主导，而单核细胞激活在无休克的革兰阴性脓毒症患者中较为常见。然而，主要发现是免疫激活和免疫抑制在个体间存在很大差异，且在休克患者中与预后无关。所分析的单核细胞和淋巴细胞标志物在个体间的显著差异有力地表明，当考虑对脓毒症患者进行免疫调节治疗时，应根据详细的免疫状态评估进行个性化治疗。
Immune activation is a regular feature of sepsis, but the incidence and nature of the ensuing inflammation-resolving and immunosuppressive component is less well understood. In this study, we compared immunoregulatory markers on blood leukocytes from patients with Gram-negative or Gram-positive sepsis or septic shock, and compared this to blood from patients with severe virosis or healthy controls. To this end, blood from 32 patients with sepsis, including ten cases with shock, and 12 patients with severe virosis were analysed by flow cytometry for the expression levels of monocyte HLA-DR, CD11c, CD14 and CD40, and for frequencies of CD163+-suppressive monocytes, HLA-DR+ or CD40+-activated T cells and Tregs. Plasma cytokine levels were analysed as a functional measurement. Signs of immunosuppression dominated in the septic shock and Gram-positive sepsis groups, whereas monocyte activation was common in Gram-negative sepsis patients without shock. However, the main finding was the large inter-individual variation of immune activation and immunosuppression, with no correlation to prognosis among the shock patients. The pronounced inter-individual variation in the analysed monocyte and lymphocyte markers forms a strong argument that, when immunomodulatory treatment is considered in a sepsis patient, it should be personalised and guided by a detailed immune status assessment.
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影响因子：
3.7
作者：
Brunialti MK;Santos MC;Rigato O;Machado FR;Silva E;Salomao R
通讯作者：
Salomao R
影响因子：
120.7
作者：
Boomer, Jonathan S.;To, Kathleen;Chang, Kathy C.;Takasu, Osamu;Osborne, Dale F.;Walton, Andrew H.;Bricker, Traci L.;Jarman, Stephen D., II;Kreisel, Daniel;Krupnick, Alexander S.;Srivastava, Anil;Swanson, Paul E.;Green, Jonathan M.;Hotchkiss, Richard S.
通讯作者：
Hotchkiss, Richard S.
影响因子：
4.6
作者：
Amlot, PL;Tahami, F;Rawlings, E
通讯作者：
Rawlings, E
DOI：
10.1073/pnas.1115761109
发表时间：
2012-01-24
影响因子：
11.1
作者：
Barreiro, Luis B.;Tailleux, Ludovic;Gilad, Yoav
通讯作者：
Gilad, Yoav
影响因子：
3.7
作者：
Janols, Helena;Bredberg, Anders;Wullt, Marlene
通讯作者：
Wullt, Marlene