| Título : |
Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis : a longitudinal study |
| Tipo de documento : |
documento electrónico |
| Autores : |
Fabián Alberto Jaimes Barragán, |
| Fecha de publicación : |
2014 |
| Títulos uniformes : |
Critical Care Medicine
|
| Idioma : |
Inglés (eng) |
| Palabras clave : |
Immunosuppression longitudinal studies physio pathology secondary infection sepsis survival |
| Resumen : |
Objectives: To perform a complete immunological characterization of compensatory anti-inflammatory response syndrome in patients with sepsis and to explore the relationship between these changes and clinical outcomes of 28-day mortality and secondary infections. Design: Prospective single-center study conducted between April 2011 and December 2012. Setting: ICUs from Hospital Universitario San Vicente Fundación at Medellin, Colombia. Patients: One hundred forty-eight patients with severe sepsis. Interventions: None. Measurements and Main Results: At days 0, 1, 3, 5, 10, and 28, we determined the expression of HLA-DR in monocytes and the apoptosis and the proliferation index in T lymphocytes, as well as the levels of tumor necrosis factor-α, interleukin-6, interleukin-1β, interleukin-10, and transforming growth factor-β in both plasma and cell culture supernatants of peripheral blood mononuclear cells. The mean percentage of HLA-DR+ was 60.7 at enrollment and increased by 0.9% (95% CI, 0.7–1.2%) per day. The mean percentage of CD4 T cells and CD8 T cells AV+/7-AAD– at enrollment was 37.2% and 20.4%, respectively, but it diminished at a rate of –0.5% (95% CI, –0.7% to –0.3%) and –0.3% (95% CI, –0.4% to –0.2%) per day, respectively. Plasma levels of interleukin-6 and interleukin-10 were 290 and 166 pg/mL and decreased at a rate of –7.8 pg/mL (95% CI, –9.5 to –6.1 pg/mL) and –4 pg/mL (95% CI, –5.1 to –2.8 pg/mL) per day, respectively. After controlling for confounders, only sustained plasma levels of interleukin-6 increase the risk of death (hazard ratio 1.003; 95% CI, 1.001–1.006). Conclusions: We found no evidence to support a two-phase model of sepsis pathophysiology. However, immunological variables did behave in a mixed and time-dependent manner. Further studies should evaluate changes over time of interleukin-6 plasma levels as a prognostic biomarker for critically ill patients. |
| Mención de responsabilidad : |
Henry G Gomez, Sandra M Gonzalez, Jessica M Londoño, Natalia A Hoyos, Cesar D Niño, Alba L Leon, Paula A Velilla, Maria T Rugeles, Fabián A Jaimes |
| Referencia : |
Crit Care Med. 2014 Apr;42(4):771-80. |
| DOI (Digital Object Identifier) : |
10.1097/CCM.0000000000000100 |
| PMID : |
24365860 |
| En línea : |
https://journals.lww.com/ccmjournal/Abstract/2014/04000/Immunological_Characteri [...] |
| Enlace permanente : |
https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis |
Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis : a longitudinal study [documento electrónico] / Fabián Alberto Jaimes Barragán, . - 2014. Obra : Critical Care MedicineIdioma : Inglés ( eng)
| Palabras clave : |
Immunosuppression longitudinal studies physio pathology secondary infection sepsis survival |
| Resumen : |
Objectives: To perform a complete immunological characterization of compensatory anti-inflammatory response syndrome in patients with sepsis and to explore the relationship between these changes and clinical outcomes of 28-day mortality and secondary infections. Design: Prospective single-center study conducted between April 2011 and December 2012. Setting: ICUs from Hospital Universitario San Vicente Fundación at Medellin, Colombia. Patients: One hundred forty-eight patients with severe sepsis. Interventions: None. Measurements and Main Results: At days 0, 1, 3, 5, 10, and 28, we determined the expression of HLA-DR in monocytes and the apoptosis and the proliferation index in T lymphocytes, as well as the levels of tumor necrosis factor-α, interleukin-6, interleukin-1β, interleukin-10, and transforming growth factor-β in both plasma and cell culture supernatants of peripheral blood mononuclear cells. The mean percentage of HLA-DR+ was 60.7 at enrollment and increased by 0.9% (95% CI, 0.7–1.2%) per day. The mean percentage of CD4 T cells and CD8 T cells AV+/7-AAD– at enrollment was 37.2% and 20.4%, respectively, but it diminished at a rate of –0.5% (95% CI, –0.7% to –0.3%) and –0.3% (95% CI, –0.4% to –0.2%) per day, respectively. Plasma levels of interleukin-6 and interleukin-10 were 290 and 166 pg/mL and decreased at a rate of –7.8 pg/mL (95% CI, –9.5 to –6.1 pg/mL) and –4 pg/mL (95% CI, –5.1 to –2.8 pg/mL) per day, respectively. After controlling for confounders, only sustained plasma levels of interleukin-6 increase the risk of death (hazard ratio 1.003; 95% CI, 1.001–1.006). Conclusions: We found no evidence to support a two-phase model of sepsis pathophysiology. However, immunological variables did behave in a mixed and time-dependent manner. Further studies should evaluate changes over time of interleukin-6 plasma levels as a prognostic biomarker for critically ill patients. |
| Mención de responsabilidad : |
Henry G Gomez, Sandra M Gonzalez, Jessica M Londoño, Natalia A Hoyos, Cesar D Niño, Alba L Leon, Paula A Velilla, Maria T Rugeles, Fabián A Jaimes |
| Referencia : |
Crit Care Med. 2014 Apr;42(4):771-80. |
| DOI (Digital Object Identifier) : |
10.1097/CCM.0000000000000100 |
| PMID : |
24365860 |
| En línea : |
https://journals.lww.com/ccmjournal/Abstract/2014/04000/Immunological_Characteri [...] |
| Enlace permanente : |
https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis |
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Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis : a longitudinal study
