Depressed Monocytic Activity may be a Predictor for Sepsis.
Depressed Monocytic Activity may be a Predictor for Sepsis.
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DOI：
10.4103/0974-2727.154785
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发表时间：
2015-01-01
影响因子：
1.1
通讯作者：
Misra, Mahesh Chandra
中科院分区：
文献类型：
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作者：
Bhardwaj, Nidhi;Mathur, Purva;Misra, Mahesh Chandra
引言：创伤是全球死亡的主要原因之一，感染是此类患者死亡的重要原因。细菌感染导致单核细胞活化，促炎细胞因子过度合成。因此，本前瞻性研究进行评估的活性单核细胞在创伤脓毒症患者使用流式细胞术，并评估他们是否有任何预后potential.MATERIALS和METHODS：共16个连续创伤脓毒症患者，并具有阳性血培养入组，沿着与四个健康对照在2013年3月至2013年7月期间。在血培养呈阳性的同一天以及此后的第2天和第5天，采集脓毒症患者的血液。用CD 14对单核细胞进行表面染色，用白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）进行细胞内染色，并通过流式细胞仪分析结果。使用MiniVidas进行降钙素原（PCT）测定。结果：16例患者中，4例死于各种微生物感染。在入选的脓毒症患者中，孤立性腹部创伤（25%）是最常见的损伤。与健康对照组相比，当用脂多糖刺激致死性患者时，TNF-α的水平显著降低。脓毒症患者谁生存了后续periods.CONCLUSION：TNF-α的水平增加，这项研究表明，单核细胞产生TNF-α和IL-6的活性在严重脓毒症减少。早期识别这种免疫瘫痪可以帮助早期干预，以挽救这一脆弱的创伤人群。
INTRODUCTION: Trauma is one of the leading causes of mortality worldwide with infections as important causes of death in such patients. Bacterial infections cause activation of monocytes with excessive synthesis of pro-inflammatory cytokines. Hence, this prospective study was conducted to assess the activity of monocytes in traumatized sepsis patients using flow cytometry and to assess if they have any prognostic potential.MATERIALS AND METHODS: A total of 16 consecutive trauma patients with sepsis and having positive blood culture were enrolled, along with four healthy controls during the period of March 2013 to July 2013. Blood from septic patients were collected on the same day when blood culture was positive and on days 2 and 5 thereafter. Surface staining for monocytes with CD14 and intracellular staining for interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) was done and results were analyzed by flow cytometer. Procalcitonin (PCT) assay was done using MiniVidas. Complete clinical follow-up was done for the patients.RESULTS: Of the 16 patients, four died due to infections by various microorganisms. Isolated abdominal trauma (25%) was the most common injury among the enrolled patients of sepsis. Levels of TNF-alpha were significantly decreased when stimulated with lipopolysaccharide in the fatal patients as compared to the healthy controls. Patients having sepsis who survived had an increased level of TNF-alpha during the follow-up periods.CONCLUSION: This study showed that activity of monocytes to produce TNF-alpha and IL-6 were reduced in severe sepsis. Early identification of such immune-paralysis can help in earlier intervention to salvage this vulnerable trauma population.