Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection

被引：105

作者：

Gogos, Charalambos ^{[2
]}

Kotsaki, Antigone ^{[1
]}

Pelekanou, Aimilia ^{[1
]}

Giannikopoulos, George ^{[3
]}

Vaki, Ilia ^{[1
]}

Maravitsa, Panagiota ^{[1
]}

Adamis, Stephanos ^{[4
]}

Alexiou, Zoi ^{[5
]}

Andrianopoulos, George ^{[6
]}

Antonopoulou, Anastasia ^{[1
]}

Athanassia, Sofia ^{[1
]}

Baziaka, Fotini ^{[1
]}

Charalambous, Aikaterini ^{[7
]}

Christodoulou, Sofia ^{[8
]}

Dimopoulou, Ioanna ^{[9
]}

Floros, Ioannis ^{[10
]}

Giannitsioti, Efthymia ^{[1
]}

Gkanas, Panagiotis ^{[11
]}

Ioakeimidou, Aikaterini ^{[12
]}

Kanellakopoulou, Kyriaki ^{[1
]}

Karabela, Niki ^{[12
]}

Karagianni, Vassiliki ^{[1
]}

Katsarolis, Ioannis ^{[1
]}

Kontopithari, Georgia ^{[9
]}

Kopterides, Petros ^{[9
]}

Koutelidakis, Ioannis ^{[13
]}

Koutoukas, Pantelis ^{[1
]}

Kranidioti, Hariklia ^{[1
]}

Lignos, Michalis ^{[9
]}

Louis, Konstantinos ^{[1
]}

Lymberopoulou, Korina ^{[14
]}

Mainas, Efstratios ^{[15
]}

Marioli, Androniki ^{[14
]}

Massouras, Charalambos ^{[1
]}

Mavrou, Irini ^{[9
]}

Mpalla, Margarita ^{[7
]}

Michalia, Martha ^{[16
]}

Mylona, Heleni ^{[17
]}

Mytas, Vassilios ^{[4
]}

Papanikolaou, Ilias ^{[17
]}

Papanikolaou, Konstantinos ^{[18
]}

Patrani, Maria ^{[12
]}

Perdios, Ioannis ^{[8
]}

Plachouras, Diamantis ^{[1
]}

Pistiki, Aikaterini ^{[1
]}

Protopapas, Konstantinos ^{[1
]}

Rigaki, Kalliopi ^{[12
]}

Sakka, Vissaria ^{[1
]}

Sartzi, Monika ^{[5
]}

Skouras, Vassilios ^{[18
]}

机构：

[1] Univ Athens, Sch Med, ATTIKON Gen Hosp, Dept Internal Med 4, Athens 12462, Greece

[2] Univ Patras, Sch Med, Dept Internal Med 1, Rion 26504, Greece

[3] Chios Gen Hosp, Dept Internal Med, Chios 82100, Greece

[4] Sismanogle Athens Hosp, Dept Urol 2, Maroussi 15126, Greece

[5] Thrias Elefsina Gen Hosp, Dept Internal Med 1, Leoforos Gennimata 19600, Magoula, Greece

[6] Argos Gen Hosp, Dept Internal Med, Argos, Greece

[7] Ippokrate Athens Gen Hosp, Intens Care Unit, Athens 11527, Greece

[8] G Gennimatas Athens Hosp, Dept Internal Med 1, Athens 11527, Greece

[9] Univ Athens, Sch Med, ATTIKON Gen Hosp, Dept Crit Care 2, Athens 12462, Greece

[10] Laikon Athens Gen Hosp, Intens Care Unit, Athens 11527, Greece

[11] Nafpl Gen Hosp, Dept Surg, Nafpion 21100, Greece

[12] Korgialeneion Benake Hosp Athens, Intens Care Unit, Athens 11526, Greece

[13] Univ Thessaloniki, Sch Med, Dept Surg 2, Thessaloniki 54635, Greece

[14] Sismanogle Athens Hosp, Dept Internal Med 2, Maroussi 15126, Greece

[15] Aghia Olga Athens Gen Hosp, Intens Care Unit, Nea Ioania 14233, Greece

[16] Thriassio Elefsina Gen Hosp, Intens Care Unit, Leoforos Gennimata 19600, Magoula, Greece

[17] Sismanogl Athens Hosp, Dept Pulm Med 3, Maroussi 15126, Greece

[18] Evangelismos Athens Hosp, Dept Internal Med 5, Athens 10676, Greece

[19] Univ Athens, Sch Med, Dept Propedeut Surg 1, GR-11527 Athens, Greece

来源：

CRITICAL CARE | 2010年 / 14卷 / 03期

关键词：

VENTILATOR-ASSOCIATED PNEUMONIA; ANTIBIOTIC-THERAPY; NK CELLS; DEFINITIONS; ENDOTOXEMIA; MORTALITY; DIAGNOSIS; CONSENSUS; DEATH;

D O I：

10.1186/cc9031

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: Although major changes of the immune system have been described in sepsis, it has never been studied whether these may differ in relation to the type of underlying infection or not. This was studied for the first time. Methods: The statuses of the innate and adaptive immune systems were prospectively compared in 505 patients. Whole blood was sampled within less than 24 hours of advent of sepsis; white blood cells were stained with monoclonal antibodies and analyzed though a flow cytometer. Results: Expression of HLA-DR was significantly decreased among patients with severe sepsis/shock due to acute pyelonephritis and intraabdominal infections compared with sepsis. The rate of apoptosis of natural killer (NK) cells differed significantly among patients with severe sepsis/shock due to ventilator-associated pneumonia (VAP) and hospital-acquired pneumonia (HAP) compared with sepsis. The rate of apoptosis of NKT cells differed significantly among patients with severe sepsis/shock due to acute pyelonephritis, primary bacteremia and VAP/HAP compared with sepsis. Regarding adaptive immunity, absolute counts of CD4-lymphocytes were significantly decreased among patients with severe sepsis/shock due to community-acquired pneumonia (CAP) and intraabdominal infections compared with sepsis. Absolute counts of B-lymphocytes were significantly decreased among patients with severe sepsis/shock due to CAP compared with sepsis. Conclusions: Major differences of the early statuses of the innate and adaptive immune systems exist between sepsis and severe sepsis/shock in relation to the underlying type of infection. These results may have a major impact on therapeutics.

引用

页数：12

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