Pro- and anti-inflammatory responses are regulated simultaneously from the first moments of septic shock
Pro- and anti-inflammatory responses are regulated simultaneously from the first moments of septic shock
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DOI：
10.1684/ecn.2011.0281
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发表时间：
2011-06-01
影响因子：
2.8
通讯作者：
Bermejo-Martin, Jesus F.
中科院分区：
文献类型：
--
作者：
Tamayo, Eduardo;Fernandez, Ana;Bermejo-Martin, Jesus F.
目前对感染性休克中细胞因子反应之间的关系知之甚少。一些研究指出了双相模型，即最初的促炎阶段，随后是反应性抗炎反应，以解释最严重形式的脓毒症的发病机制。然而，已经发现了两种反应共存的证据。在这项研究中，分析和比较了 20 名感染性休克患者、11 名全身炎症反应综合征 (SIRS) 患者在诊断后 24 小时内以及 10 名健康对照者的 17 种细胞因子和趋化因子的血浆水平。与健康对照相比，感染性休克患者的 IL-6、IL-8、MCP-1、MIP-1 beta、IFN-γ、GM-CSF 和 IL-10 水平升高。 SIRS 患者的 IL-6、IL-8、MCP-1、MIP-1β、G-CSF 和 IL-10 水平高于对照组。脓毒性休克患者的 IL-8、GM-CSF、MIP-1 β 水平高于 SIRS 患者。 Spearman 试验表明，脓毒性休克中促炎介质 IL-6、IL-8、MCP-1、MIP-1 beta、IFN-gamma、GM-CSF 与免疫调节细胞因子 IL-10 之间呈正相关。因此，相关研究支持这样的观点：感染性休克中促炎介质和抗炎介质的分泌是在病程早期启动的同步免疫反应程序，揭示了两种类型的细胞因子从这种危及生命的疾病一开始就发挥着作用。
The relationships between cytokine responses in septic shock are currently poorly understood. Some studies have pointed to a biphasic model, with an initial proinflammatory phase, followed by a reactive, anti-inflammatory response to explain the pathogenesis of the most severe form of sepsis. However, evidence for the coexistence of both responses has been found. In this study, the plasma levels of 17 cytokines and chemokines, in 20 patients with septic shock, 11 patients with systemic inflammatory response syndrome (SIRS), during the first 24 hours following diagnosis, and 10 healthy controls, were analyzed and compared. Patients with septic shock showed increased levels of IL-6, IL-8, MCP-1, MIP-1 beta, IFN-gamma, GM-CSF and IL-10 compared to healthy controls. Patients with SIRS showed higher levels of IL-6, IL-8, MCP-1, MIP-1 beta, G-CSF and IL-10 than controls. Patients with septic shock showed higher levels of IL-8, GM-CSF, MIP-1 beta than those with SIRS. The Spearman test demonstrated a positive association between the pro-inflammatory mediators IL-6, IL-8, MCP-1, MIP-1 beta, IFN-gamma, GM-CSF and the immunomodulatory cytokine IL-10 in septic shock. Consequently, correlation studies supported the notion that secretion of pro- and anti-inflammatory mediators in septic shock occurs as a simultaneous immune response program initiated early in the course of the disease, revealing that both types of cytokine play a role from the very beginning of this life-threatening condition.