Clinical review: a paradigm shift: the bidirectional effect of inflammation on bacterial growth. Clinical implications for patients with acute respiratory distress syndrome.
Clinical review: a paradigm shift: the bidirectional effect of inflammation on bacterial growth. Clinical implications for patients with acute respiratory distress syndrome.
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DOI：
10.1186/cc1450
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发表时间：
2002-02
期刊：
影响因子：
--
通讯作者：
Meduri GU
中科院分区：
文献类型：
--
作者：
Meduri GU
临床研究表明，持续和强烈的炎症反应与细菌感染的发生率之间存在正相关。我们推测，急性呼吸窘迫综合征期间宿主分泌的细胞因子可能确实有利于细菌的生长，并解释了夸张和持久的全身炎症与医院感染频繁发生之间的关系。为了验证这一假设，我们进行了体外研究，评价了三种临床相关细菌对不同浓度的促炎细胞因子肿瘤坏死因子-α、IL-1β和IL-6的细胞外和细胞内生长反应。在这些研究中，我们确定了细菌生长对促炎细胞因子的U形反应。当细菌在体外暴露于较低浓度的细胞因子时，细胞外和细胞内细菌生长不被促进，并且人单核细胞有效地杀死摄入的细菌。相反，当细菌暴露于更高浓度的促炎细胞因子时，细胞内和细胞外细菌生长以剂量依赖性方式增强。促炎细胞因子对细菌生长的双向作用可能有助于解释急性呼吸窘迫综合征患者医院感染的频繁发生。
Clinical studies have shown positive associations among sustained and intense inflammatory responses and the incidence of bacterial infections. We hypothesized that cytokines secreted by the host during acute respiratory distress syndrome may indeed favor the growth of bacteria and explain the association between exaggerated and protracted systemic inflammation and the frequent development of nosocomial infections. To test this hypothesis, we conducted in vitro studies evaluating the extracellular and intracellular growth response of three clinically relevant bacteria in response to graded concentrations of pro-inflammatory cytokines tumor necrosis factor-α, IL-1β, and IL-6. In these studies, we identified a U-shaped response of bacterial growth to pro-inflammatory cytokines. When the bacteria were exposed in vitro to a lower concentration of cytokines, extracellular and intracellular bacterial growth was not promoted and human monocytic cells were efficient in killing the ingested bacteria. Conversely, when bacteria were exposed to higher concentrations of pro-inflammatory cytokines, intracellular and extracellular bacterial growth was enhanced in a dose-dependent manner. The bidirectional effects of proinflammatory cytokines on bacterial growth may help to explain the frequent occurrence of nosocomial infections in patients with unresolving acute respiratory distress syndrome.
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DOI：
10.1164/ajrccm.152.1.7599829
发表时间：
1995-07-01
影响因子：
24.7
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发表时间：
1999-09-01
影响因子：
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