Immune function testing in sepsis patients receiving sodium selenite
Immune function testing in sepsis patients receiving sodium selenite
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DOI：
10.1016/j.jcrc.2019.05.001
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发表时间：
2019-08-01
影响因子：
3.7
通讯作者：
Chouker, Alexander
中科院分区：
文献类型：
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作者：
Guo, Anne;Srinath, Jyotsna;Chouker, Alexander
目的：我们在一项纵向研究中研究了亚硒酸钠在脓毒症患者中使用免疫功能测定增强全血样本免疫性能的作用。材料和方法：这是一项在 www.clinicaltrials.gov (NCT00832039) 注册的随机、双盲多中心临床试验 (SISPCT) 的子研究，数据收集自我们中心。将全血样本与各种回忆抗原一起孵育，并测量上清液的细胞因子浓度，作为免疫反应的标记。使用 R 中的广义最小二乘模型分析第 0、4、7、14 和 21 天（脓毒症发作时）的数据，以适当考虑纵向结构和缺失值。结果：在我们中心参加研究的 76 名患者中，40 名随机接受硒治疗，36 名随机接受安慰剂。免疫反应测定数据的分析显示，硒组和安慰剂组在每个时间点没有统计学差异。然而，两组细胞因子的释放总体上受到抑制，随着时间的推移，细胞因子的释放往往会恢复。结论：硒长期以来一直是治疗脓毒症的辅助疗法。最近，它被证明对死亡率结果没有有益影响。使用我们中心在这项亚队列研究中的数据，我们发现在三周内接受硒治疗的患者体内受刺激的血液免疫细胞的细胞因子释放没有相对改善。这为硒对脓毒症患者缺乏有益作用提供了可能的解释。 (C) 2019 年由爱思唯尔公司出版
Purpose: We examined in a longitudinal study the role of sodium selenite in sepsis patents in strengthening the immune performance in whole blood samples using immune functional assays.Materials and methods: This was a sub-study from a randomized, double blinded multicenter clinical trial (SISPCT) registered with www.clinicaltrials.gov (NCT00832039) and with data collected al our center. Full blood samples were incubated with various recall antigens and the supernatants were measured for their cytokine concentrations as markers for immune response. Data from days 0,4, 7, 14, and 21 (from sepsis onset) were analyzed using a generalized least squares model in R to appropriately take the longitudinal structure and the missing values into account.Results: From the 76 patients enrolled in the study at our center, 40 were randomized to selenium therapy and 36 to placebo. The analyses of immune response assay data showed no statistical difference between the selenium and placebo groups at each of the time points. There was however an overall dampening of cytokine release, which tended to recover over time in both groups.Conclusion: Selenium has long been an adjuvant therapy in treating sepsis. Recently, it was proven to not have beneficial effects on the mortality outcome. Using data from our center in this sub-cohort study, we identified no relative improvement in cytokine release of stimulated blood immune cells ex vivo from patients with selenium therapy over a three-week period. This offers a potential explanation for the lack of beneficial effects of selenium in sepsis patients. (C) 2019 Published by Elsevier Inc.