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Brusletto BS, Hellerud BC, Øvstebø R, Brandtzaeg P. Neisseria meningitidis accumulate in large organs during meningococcal sepsis. Front Cell Infect Microbiol 2023; 13:1298360. [PMID: 38089821 PMCID: PMC10713808 DOI: 10.3389/fcimb.2023.1298360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Neisseria meningitidis (Nm) is the cause of epidemic meningitis and fulminant meningococcal septicemia. The clinical presentations and outcome of meningococcal septic shock is closely related to the circulating levels of lipopolysaccharides (LPS) and of Neisseria meningitidis DNA (Nm DNA). We have previously explored the distribution of Nm DNA in tissues from large organs of patients dying of meningococcal septic shock and in a porcine meningococcal septic shock model. Objective 1) To explore the feasibility of measuring LPS levels in tissues from the large organs in patients with meningococcal septic shock and in a porcine meningococcal septic shock model. 2) To evaluate the extent of contamination of non-specific LPS during the preparation of tissue samples. Patients and methods Plasma, serum, and fresh frozen (FF) tissue samples from the large organs of three patients with lethal meningococcal septic shock and two patients with lethal pneumococcal disease. Samples from a porcine meningococcal septic shock model were included. Frozen tissue samples were thawed, homogenized, and prepared for quantification of LPS by Pyrochrome® Limulus Amoebocyte Lysate (LAL) assay. Results N. meningitidis DNA and LPS was detected in FF tissue samples from large organs in all patients with meningococcal septic shock. The lungs are the organs with the highest LPS and Nm DNA concentration followed by the heart in two of the three meningococcal shock patients. Nm DNA was not detected in any plasma or tissue sample from patients with lethal pneumococcal infection. LPS was detected at a low level in all FF tissues from the two patients with lethal pneumococcal disease. The experimental porcine meningococcal septic shock model indicates that also in porcinis the highest LPS and Nm DNA concentration are detected in lungs tissue samples. The quantification analysis showed that the highest concentration of both Nm DNA and LPS are in the organs and not in the circulation of patients with lethal meningococcal septic shock. This was also shown in the experimental porcine meningococcal septic shock model. Conclusion Our results suggest that LPS can be quantified in mammalian tissues by using the LAL assay.
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Affiliation(s)
| | | | - Reidun Øvstebø
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Petter Brandtzaeg
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Pediatrics, Oslo University Hospital, Nydalen, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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2
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The Potential Importance of CXCL1 in the Physiological State and in Noncancer Diseases of the Cardiovascular System, Respiratory System and Skin. Int J Mol Sci 2022; 24:ijms24010205. [PMID: 36613652 PMCID: PMC9820720 DOI: 10.3390/ijms24010205] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
In this paper, we present a literature review of the role of CXC motif chemokine ligand 1 (CXCL1) in physiology, and in selected major non-cancer diseases of the cardiovascular system, respiratory system and skin. CXCL1, a cytokine belonging to the CXC sub-family of chemokines with CXC motif chemokine receptor 2 (CXCR2) as its main receptor, causes the migration and infiltration of neutrophils to the sites of high expression. This implicates CXCL1 in many adverse conditions associated with inflammation and the accumulation of neutrophils. The aim of this study was to describe the significance of CXCL1 in selected diseases of the cardiovascular system (atherosclerosis, atrial fibrillation, chronic ischemic heart disease, hypertension, sepsis including sepsis-associated encephalopathy and sepsis-associated acute kidney injury), the respiratory system (asthma, chronic obstructive pulmonary disease (COPD), chronic rhinosinusitis, coronavirus disease 2019 (COVID-19), influenza, lung transplantation and ischemic-reperfusion injury and tuberculosis) and the skin (wound healing, psoriasis, sunburn and xeroderma pigmentosum). Additionally, the significance of CXCL1 is described in vascular physiology, such as the effects of CXCL1 on angiogenesis and arteriogenesis.
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3
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Tuerxun K, Midtbö K, Särndahl E, Vorontsov E, Karlsson R, Persson A, Kruse R, Eklund D. Cytokine responses to LPS in reprogrammed monocytes are associated with the transcription factor PU.1. J Leukoc Biol 2022; 112:679-692. [PMID: 35285058 PMCID: PMC9790682 DOI: 10.1002/jlb.3a0421-216r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 01/21/2022] [Accepted: 01/30/2022] [Indexed: 12/30/2022] Open
Abstract
Myeloid-derived suppressor cells (MDSCs) are functionally immunosuppressive cells that arise and expand during extensive inflammatory conditions by increased hematopoietic output or reprogramming of immune cells. In sepsis, an increase of circulating MDSCs is associated with adverse outcomes, but unique traits that can be used to identify increased activity of MDSCs are lacking. By using endotoxin tolerance as a model of sepsis-induced monocytic MDSCs (M-MDSC-like cells), this study aims to identify the mediator and transcriptional regulator profile associated with M-MDSC activity. After analyzing 180 inflammation-associated proteins, a profile of differentially expressed cytokines was found in M-MDSC-like cells versus normal monocytes stimulated with LPS. These cytokines were associated with 5 candidate transcription factors, where particularly PU.1 showed differential expression on both transcriptional and protein levels in M-MDSC-like cells. Furthermore, inhibition of PU.1 led to increased production of CXCL5 and CCL8 in M-MDSC-like cells indicating its role in regulating the ability of M-MDSC-like cells to recruit other immune cells. Taken together, the study identifies a unique profile in the pattern of immune mediators defining M-MDSC activity upon LPS stimulation, which offers a functional link to their contribution to immunosuppression.
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Affiliation(s)
- Kedeye Tuerxun
- Faculty of Medicine and Health, School of Medical SciencesÖrebro UniversityÖrebroSweden,Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Kristine Midtbö
- Faculty of Medicine and Health, School of Medical SciencesÖrebro UniversityÖrebroSweden,Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Eva Särndahl
- Faculty of Medicine and Health, School of Medical SciencesÖrebro UniversityÖrebroSweden,Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Egor Vorontsov
- Proteomics Core Facility, Sahlgrenska AcademyUniversity of GothenburgSweden
| | - Roger Karlsson
- Department of Infectious Diseases, Institute of BiomedicineSahlgrenska Academy of the University of GothenburgSweden,Department of Clinical MicrobiologySahlgrenska University Hospital, Region Västra GötalandSweden,Nanoxis Consulting ABGothenburgSweden
| | - Alexander Persson
- Faculty of Medicine and Health, School of Medical SciencesÖrebro UniversityÖrebroSweden,Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Robert Kruse
- Faculty of Medicine and Health, School of Medical SciencesÖrebro UniversityÖrebroSweden,Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden,Department of Clinical Research Laboratory, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Daniel Eklund
- Faculty of Medicine and Health, School of Medical SciencesÖrebro UniversityÖrebroSweden,Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
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4
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Utrero-Rico A, González-Cuadrado C, Chivite-Lacaba M, Cabrera-Marante O, Laguna-Goya R, Almendro-Vazquez P, Díaz-Pedroche C, Ruiz-Ruigómez M, Lalueza A, Folgueira MD, Vázquez E, Quintas A, Berges-Buxeda MJ, Martín-Rodriguez M, Dopazo A, Serrano-Hernández A, Aguado JM, Paz-Artal E. Alterations in Circulating Monocytes Predict COVID-19 Severity and Include Chromatin Modifications Still Detectable Six Months after Recovery. Biomedicines 2021; 9:1253. [PMID: 34572439 PMCID: PMC8471575 DOI: 10.3390/biomedicines9091253] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
An early analysis of circulating monocytes may be critical for predicting COVID-19 course and its sequelae. In 131 untreated, acute COVID-19 patients at emergency room arrival, monocytes showed decreased surface molecule expression, including low HLA-DR, in association with an inflammatory cytokine status and limited anti-SARS-CoV-2-specific T cell response. Most of these alterations had normalized in post-COVID-19 patients 6 months after discharge. Acute COVID-19 monocytes transcriptome showed upregulation of anti-inflammatory tissue repair genes such as BCL6, AREG and IL-10 and increased accessibility of chromatin. Some of these transcriptomic and epigenetic features still remained in post-COVID-19 monocytes. Importantly, a poorer expression of surface molecules and low IRF1 gene transcription in circulating monocytes at admission defined a COVID-19 patient group with impaired SARS-CoV-2-specific T cell response and increased risk of requiring intensive care or dying. An early analysis of monocytes may be useful for COVID-19 patient stratification and for designing innate immunity-focused therapies.
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Affiliation(s)
- Alberto Utrero-Rico
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Cecilia González-Cuadrado
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Marta Chivite-Lacaba
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Oscar Cabrera-Marante
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Rocío Laguna-Goya
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Patricia Almendro-Vazquez
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Carmen Díaz-Pedroche
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - María Ruiz-Ruigómez
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Antonio Lalueza
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - María Dolores Folgueira
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Microbiology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Enrique Vázquez
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (E.V.); (A.Q.); (A.D.)
| | - Ana Quintas
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (E.V.); (A.Q.); (A.D.)
| | - Marcos J. Berges-Buxeda
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Moisés Martín-Rodriguez
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Ana Dopazo
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (E.V.); (A.Q.); (A.D.)
| | - Antonio Serrano-Hernández
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - José María Aguado
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Estela Paz-Artal
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
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5
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Kahn R, Schmidt T, Golestani K, Mossberg A, Gullstrand B, Bengtsson AA, Kahn F. Mismatch between circulating cytokines and spontaneous cytokine production by leukocytes in hyperinflammatory COVID-19. J Leukoc Biol 2020; 109:115-120. [PMID: 32794348 PMCID: PMC7436862 DOI: 10.1002/jlb.5covbcr0720-310rr] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 12/12/2022] Open
Abstract
The disease COVID‐19 has developed into a worldwide pandemic. Hyperinflammation and high levels of several cytokines, for example, IL‐6, are observed in severe COVID‐19 cases. However, little is known about the cellular origin of these cytokines. Here, we investigated whether circulating leukocytes from patients with COVID‐19 had spontaneous cytokine production. Patients with hyperinflammatory COVID‐19 (n = 6) and sepsis (n = 3) were included at Skåne University Hospital, Sweden. Healthy controls were also recruited (n = 5). Cytokines were measured in COVID‐19 and sepsis patients using an Immulite immunoassay system. PBMCs were cultured with brefeldin A to allow cytokine accumulation. In parallel, LPS was used as an activator. Cells were analyzed for cytokines and surface markers by flow cytometry. High levels of IL‐6 and measurable levels of IL‐8 and TNF, but not IL‐1β, were observed in COVID‐19 patients. Monocytes from COVID‐19 patients had spontaneous production of IL‐1β and IL‐8 (P = 0.0043), but not of TNF and IL‐6, compared to controls. No spontaneous cytokine production was seen in lymphocytes from either patients or controls. Activation with LPS resulted in massive cytokine production by monocytes from COVID‐19 patients and healthy controls, but not from sepsis patients. Finally, monocytes from COVID‐19 patients produced more IL‐1β than from healthy controls (P = 0.0087) when activated. In conclusion, monocytes contribute partly to the ongoing hyperinflammation by production of IL‐1β and IL‐8. Additionally, they are responsive to further activation. This data supports the notion of IL‐1β blockade in treatment of COVID‐19. However, the source of the high levels of IL‐6 remains to be determined.
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Affiliation(s)
- Robin Kahn
- Department of Clinical Sciences Lund, Section of Pediatrics, Lund University, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Lund and Malmö, Sweden
| | - Tobias Schmidt
- Department of Clinical Sciences Lund, Section of Pediatrics, Lund University, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | | | - Anki Mossberg
- Department of Clinical Sciences Lund, Section of Pediatrics, Lund University, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Birgitta Gullstrand
- Department of Clinical Sciences Lund, Rheumatology Lund University, Lund, Sweden
| | - Anders A Bengtsson
- Department of Clinical Sciences Lund, Rheumatology Lund University, Lund, Sweden
| | - Fredrik Kahn
- Skåne University Hospital, Lund and Malmö, Sweden.,Department of Clinical Sciences Lund, Section of Infection Medicine, Lund University, Lund, Sweden
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Attenuation of Sepsis-Induced Cardiomyopathy by Regulation of MicroRNA-23b Is Mediated Through Targeting of MyD88-Mediated NF-κB Activation. Inflammation 2019; 42:973-986. [PMID: 30734878 DOI: 10.1007/s10753-019-00958-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Myocardial cell injury or cardiomyopathy is associated with excessive inflammatory response and apoptosis of cardiac myocytes during sepsis. MicroRNA-23b (miR-23b) is a multifunctional miRNA that is considered to regulate immunosuppression in sepsis. The aim of this study was to examine the effect of miR-23b on cardiomyopathy induced by sepsis and to explore the potential mechanism involved. Sprague-Dawley rats were subjected to cecal ligation and puncture (CLP), and the level of miR-23b at different time points was measured by quantitative real-time polymerase chain reaction (qPCR). Then, we overexpressed miR-23b in vivo and in vitro. The rats were subjected to CLP 7 days after transfection. Cardiac function, inflammatory response, and heart tissues were examined 3 days thereafter. In an in vitro experiment, H9C2 cardiomyoblasts were stimulated with lipopolysaccharide (LPS) after transfection of miR-23b, following which apoptosis and the level of NF-κB were analyzed. The expression of miR-23b was upregulated during polymicrobial sepsis, and transfection of miR-23b lentivirus improved the outcome of sepsis-induced cardiomyopathy by attenuating inflammatory responses and protecting against histopathological damage. In in vitro experiments, elevated miR-23b inhibited excessive apoptosis of cardiomyocytes, which may be because activation of the NF-κB signaling pathway was inhibited by the decreased levels of TRAF6 and IKKβ. Therefore, miR-23b improved sepsis-induced cardiomyopathy by attenuating the inflammatory response, suppressing apoptosis, and preventing NF-κB activation via targeted inhibition of TRAF6 and IκκB. These results indicated that miR-23b may represent a novel therapeutic approach for clinical treatment of sepsis-induced cardiomyopathy.
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Abali F, Broekmaat J, Tibbe A, Schasfoort RBM, Zeune L, Terstappen LWMM. A microwell array platform to print and measure biomolecules produced by single cells. LAB ON A CHIP 2019; 19:1850-1859. [PMID: 31041434 DOI: 10.1039/c9lc00100j] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Here we describe a combined method to monitor the secretion of molecules produced by single cells, followed by a method to isolate the individual cells that produced these molecules. The method is based on a self-sorting microwell chip that is connected to an activated membrane that collects the produced molecules. The produced molecules are printed by diffusion in small spots onto the membrane. The location of the printed spots can be correlated to the microwell number and the cell that produced these molecules. To demonstrate the method, we used the EpCAM antibody producing hybridoma cell line VU1D9 and a genetically engineered CHO cell-line producing Her2. VU1D9 cells produced 4.6 ± 5.6 pg (mean ± SD) of EpCAM antibody per 24 h and CHO cells 6.5 ± 8.2 pg per 24 h of Herceptin antibody.
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Affiliation(s)
- Fikri Abali
- Department of Medical Cell BioPhysics, University of Twente, Hallenweg 23, Enschede, 7522 NH, The Netherlands.
| | | | | | - Richard B M Schasfoort
- Department of Medical Cell BioPhysics, University of Twente, Hallenweg 23, Enschede, 7522 NH, The Netherlands.
| | - Leonie Zeune
- Department of Medical Cell BioPhysics, University of Twente, Hallenweg 23, Enschede, 7522 NH, The Netherlands.
| | - Leon W M M Terstappen
- Department of Medical Cell BioPhysics, University of Twente, Hallenweg 23, Enschede, 7522 NH, The Netherlands.
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Akkeçeci NS, Seğmen B, Yurttutan S, Acıpayam C, Dinçer Z, Öksüz G. Yenidoğan sepsisinde tam kan sayımı parametrelerinin tanısal değeri. DICLE MEDICAL JOURNAL 2019. [DOI: 10.5798/dicletip.534856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Ryan T, Coakley JD, Martin-Loeches I. Defects in innate and adaptive immunity in patients with sepsis and health care associated infection. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:447. [PMID: 29264364 DOI: 10.21037/atm.2017.09.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Recent advances in sepsis therapy exclusively involve improvements in supportive care, while sepsis mortality rates remain disturbingly high at 30%. These persistently high sepsis mortality rates arise from the absence of sepsis specific therapies. However with improvements in supportive care, patients with septic shock commonly partially recover from the infection that precipitated their initial illness, yet they frequently succumb to subsequent health care associated infections. Remarkably today the pathophysiology of sepsis in humans, a common disease in western society, remains largely a conundrum. Conventionally sepsis was regarded as primarily a disorder of inflammation. More recently the importance of immune compromise in the pathophysiology of sepsis and health care associated infection has now become more widely accepted. Accordingly a review of the human evidence for this novel sepsis paradigm is timely. Septic patients appear to exhibit a complex and long-lasting immune deficiency state, involving lymphocytes of both the innate and adaptive immune responses that have been linked with mortality and the occurrence of health care associated infection. Such is the pervasive nature of immune compromise in sepsis that ultimately immune modulation will play a crucial role in sepsis therapies of the future.
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Affiliation(s)
- Thomas Ryan
- Department of Intensive Care, St James's Hospital Dublin, Dublin, Ireland
| | - John D Coakley
- Department of Intensive Care, St James's Hospital Dublin, Dublin, Ireland
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10
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Blumhagen RZ, Hedin BR, Malcolm KC, Burnham EL, Moss M, Abraham E, Huie TJ, Nick JA, Fingerlin TE, Alper S. Alternative pre-mRNA splicing of Toll-like receptor signaling components in peripheral blood mononuclear cells from patients with ARDS. Am J Physiol Lung Cell Mol Physiol 2017; 313:L930-L939. [PMID: 28775099 DOI: 10.1152/ajplung.00247.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/28/2017] [Accepted: 07/30/2017] [Indexed: 12/14/2022] Open
Abstract
A key physiological feature of acute respiratory distress syndrome (ARDS) is inflammation. Toll-like receptor (TLR) signaling is required to combat the infection that underlies many ARDS cases but also contributes to pathological inflammation. Several TLR signaling pathway genes encoding positive effectors of inflammation also produce alternatively spliced mRNAs encoding negative regulators of inflammation. An imbalance between these isoforms could contribute to pathological inflammation and disease severity. To determine whether splicing in TLR pathways is altered in patients with ARDS, we monitored alternative splicing of MyD88 and IRAK1, two genes that function in multiple TLR pathways. The MyD88 and IRAK1 genes produce long proinflammatory mRNAs (MyD88L and IRAK1) and shorter anti-inflammatory mRNAs (MyD88S and IRAK1c). We quantified mRNA encoding inflammatory cytokines and MyD88 and IRAK1 isoforms in peripheral blood mononuclear cells (PBMCs) from 104 patients with ARDS and 30 healthy control subjects. We found that MyD88 pre-mRNA splicing is altered in patients with ARDS in a proinflammatory direction. We also observed altered MyD88 isoform levels in a second critically ill patient cohort, suggesting that these changes may not be unique to ARDS. Early in ARDS, PBMC IRAK1c levels were associated with patient survival. Despite the similarities in MyD88 and IRAK1 alternative splicing observed in previous in vitro studies, there were differences in how MyD88 and IRAK1 alternative splicing was altered in patients with ARDS. We conclude that pre-mRNA splicing of TLR signaling genes is altered in patients with ARDS, and further investigation of altered splicing may lead to novel prognostic and therapeutic approaches.
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Affiliation(s)
- Rachel Z Blumhagen
- Center for Genes, Environment and Health, National Jewish Health, Denver, Colorado.,Department of Biomedical Research, National Jewish Health, Denver, Colorado
| | - Brenna R Hedin
- Center for Genes, Environment and Health, National Jewish Health, Denver, Colorado.,Department of Biomedical Research, National Jewish Health, Denver, Colorado
| | - Kenneth C Malcolm
- Department of Medicine, National Jewish Health, Denver, Colorado.,Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado
| | - Ellen L Burnham
- Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado
| | - Marc Moss
- Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado
| | - Edward Abraham
- Office of the Dean, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Tristan J Huie
- Department of Medicine, National Jewish Health, Denver, Colorado.,Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado
| | - Jerry A Nick
- Department of Medicine, National Jewish Health, Denver, Colorado.,Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado
| | - Tasha E Fingerlin
- Center for Genes, Environment and Health, National Jewish Health, Denver, Colorado.,Department of Biomedical Research, National Jewish Health, Denver, Colorado.,Department of Biostatistics and Bioinformatics, Colorado School of Public Health, Aurora, Colorado
| | - Scott Alper
- Center for Genes, Environment and Health, National Jewish Health, Denver, Colorado; .,Department of Biomedical Research, National Jewish Health, Denver, Colorado.,Program in Mucosal Inflammation and Immunity, National Jewish Health, Denver, Colorado; and.,Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado
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11
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Wu HP, Chu CM, Kao KC, Huang SH, Chuang DY. High Interleukin-10 Expression in Type 2 T Helper Cells in Septic Patients. Immunol Invest 2017; 46:385-394. [PMID: 28375710 DOI: 10.1080/08820139.2017.1288237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Interleukin (IL)-10 response is associated with mortality in patients with sepsis. IL-10 is primarily produced by monocytes and type 2 T helper (Th2) cells. The aim of this study was to investigate differences in IL-10 production between monocytes and Th2 cells in patients with sepsis. Forty patients with sepsis and 35 healthy controls were enrolled. Cytokine expressions in peripheral blood mononuclear cells (PBMCs) were measured by flow cytometry. The IL-10 expression in the Th2 cells of the septic patients was higher than in the healthy controls, but the expression of IL-10 in the monocytes of the septic patients was lower than in the healthy controls. After regression analysis, IL-10 expression in Th2 cells was positively associated with sepsis, but IL-10 expression in monocytes was not associated with sepsis or shock. In conclusion, the production of IL-10 in Th2 cells was higher in the patients with sepsis.
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Affiliation(s)
- Huang-Pin Wu
- a Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital , Keelung , Taiwan.,b Chang Gung University College of Medicine , Taoyuan , Taiwan
| | - Chien-Ming Chu
- a Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Kuo-Chin Kao
- b Chang Gung University College of Medicine , Taoyuan , Taiwan.,c Department of Thoracic Medicine , Chang Gung Memorial Hospital , Linkou , Taiwan
| | - Shu-Huan Huang
- d Department of Medical Laboratory , Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Duen-Yau Chuang
- e Department of Chemistry , National Chung-Hsing University , Taichung , Taiwan
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12
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Gao M, Wang X, Zhang X, Ha T, Ma H, Liu L, Kalbfleisch JH, Gao X, Kao RL, Williams DL, Li C. Attenuation of Cardiac Dysfunction in Polymicrobial Sepsis by MicroRNA-146a Is Mediated via Targeting of IRAK1 and TRAF6 Expression. THE JOURNAL OF IMMUNOLOGY 2015; 195:672-82. [PMID: 26048146 DOI: 10.4049/jimmunol.1403155] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 05/12/2015] [Indexed: 01/13/2023]
Abstract
Cardiac dysfunction is a major consequence of sepsis/septic shock and contributes to the high mortality of sepsis. Innate and inflammatory responses mediated by TLRs play a critical role in sepsis-induced cardiac dysfunction. MicroRNA-146 (miR-146) was first identified as a negative regulator in innate immune and inflammatory responses induced by LPS. This study examined whether miR-146a will have a protective effect on sepsis-induced cardiac dysfunction. Lentivirus-expressing miR-146a (LmiR-146a) or lentivirus-expressing scrambled miR (LmiR-control) was delivered into the myocardium via the right carotid artery. Seven days after transfection, mice were subjected to cecal ligation and puncture (CLP). Untransfected mice were also subjected to CLP-induced sepsis. Cardiac function was examined by echocardiography before and 6 h after CLP. In vitro studies showed that increased miR-146a levels suppress LPS-induced IκBα phosphorylation and inflammatory cytokine production in both H9C2 cardiomyocytes and J774 macrophages. In vivo transfection of LmiR-146a attenuated sepsis-induced cardiac dysfunction. The values for percent ejection fraction and percent fractional shortening in LmiR-146a-transfected CLP mice were significantly greater than in untransfected CLP control. LmiR-146a transfection prevented sepsis-induced NF-κB activity, suppressed IRAK and TRAF6 expression in the myocardium, and attenuated sepsis-induced inflammatory cytokine production in both plasma and peritoneal fluid. In addition, LmiR-146a transfection decreased sepsis-induced infiltration of neutrophils and macrophages into the myocardium. LmiR-146a can also transfect macrophages in the periphery. We conclude that miR-146a attenuates sepsis-induced cardiac dysfunction by preventing NF-κB activation, inflammatory cell infiltration, and inflammatory cytokine production via targeting of IRAK and TRAF6 in both cardiomyocytes and inflammatory monocytic cells.
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Affiliation(s)
- Ming Gao
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - Xiaohui Wang
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - Xia Zhang
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - Tuanzhu Ha
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614; Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - He Ma
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - Li Liu
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - John H Kalbfleisch
- Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614; Department of Biometry and Medical Computing, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614; and
| | - Xiang Gao
- Animal Model Research Center, Nanjing University, Nanjing, 210093 China
| | - Race L Kao
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614; Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - David L Williams
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614; Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614
| | - Chuanfu Li
- Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614; Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614;
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13
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Attenuation of Cardiac Dysfunction in Polymicrobial Sepsis by MicroRNA-146a Is Mediated via Targeting of IRAK1 and TRAF6 Expression. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2015. [PMID: 26048146 DOI: 19.4049/jimmunol.1403155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cardiac dysfunction is a major consequence of sepsis/septic shock and contributes to the high mortality of sepsis. Innate and inflammatory responses mediated by TLRs play a critical role in sepsis-induced cardiac dysfunction. MicroRNA-146 (miR-146) was first identified as a negative regulator in innate immune and inflammatory responses induced by LPS. This study examined whether miR-146a will have a protective effect on sepsis-induced cardiac dysfunction. Lentivirus-expressing miR-146a (LmiR-146a) or lentivirus-expressing scrambled miR (LmiR-control) was delivered into the myocardium via the right carotid artery. Seven days after transfection, mice were subjected to cecal ligation and puncture (CLP). Untransfected mice were also subjected to CLP-induced sepsis. Cardiac function was examined by echocardiography before and 6 h after CLP. In vitro studies showed that increased miR-146a levels suppress LPS-induced IκBα phosphorylation and inflammatory cytokine production in both H9C2 cardiomyocytes and J774 macrophages. In vivo transfection of LmiR-146a attenuated sepsis-induced cardiac dysfunction. The values for percent ejection fraction and percent fractional shortening in LmiR-146a-transfected CLP mice were significantly greater than in untransfected CLP control. LmiR-146a transfection prevented sepsis-induced NF-κB activity, suppressed IRAK and TRAF6 expression in the myocardium, and attenuated sepsis-induced inflammatory cytokine production in both plasma and peritoneal fluid. In addition, LmiR-146a transfection decreased sepsis-induced infiltration of neutrophils and macrophages into the myocardium. LmiR-146a can also transfect macrophages in the periphery. We conclude that miR-146a attenuates sepsis-induced cardiac dysfunction by preventing NF-κB activation, inflammatory cell infiltration, and inflammatory cytokine production via targeting of IRAK and TRAF6 in both cardiomyocytes and inflammatory monocytic cells.
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14
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Sperber J, Lipcsey M, Larsson A, Larsson A, Sjölin J, Castegren M. Evaluating the effects of protective ventilation on organ-specific cytokine production in porcine experimental postoperative sepsis. BMC Pulm Med 2015; 15:60. [PMID: 25958003 PMCID: PMC4434882 DOI: 10.1186/s12890-015-0052-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/22/2015] [Indexed: 12/04/2022] Open
Abstract
Background Protective ventilation with lower tidal volume (VT) and higher positive end-expiratory pressure (PEEP) reduces the negative additive effects of mechanical ventilation during systemic inflammatory response syndrome. We hypothesised that protective ventilation during surgery would affect the organ-specific immune response in an experimental animal model of endotoxin-induced sepsis-like syndrome. Methods 30 pigs were laparotomised for 2 hours (h), after which a continuous endotoxin infusion was started at 0.25 micrograms × kg−1 × h−1 for 5 h. Catheters were placed in the carotid artery, hepatic vein, portal vein and jugular bulb. Animals were randomised to two protective ventilation groups (n = 10 each): one group was ventilated with VT 6 mL × kg−1 during the whole experiment while the other group was ventilated during the surgical phase with VT of 10 mL × kg−1. In both groups PEEP was 5 cmH2O during surgery and increased to 10 cmH2O at the start of endotoxin infusion. A control group (n = 10) was ventilated with VT of 10 mL × kg−1 and PEEP 5 cm H20 throughout the experiment. In four sample locations we a) simultaneously compared cytokine levels, b) studied the effect of protective ventilation initiated before and during endotoxemia and c) evaluated protective ventilation on organ-specific cytokine levels. Results TNF-alpha levels were highest in the hepatic vein, IL-6 levels highest in the artery and jugular bulb and IL-10 levels lowest in the artery. Protective ventilation initiated before and during endotoxemia did not differ in organ-specific cytokine levels. Protective ventilation led to lower levels of TNF-alpha in the hepatic vein compared with the control group, whereas no significant differences were seen in the artery, portal vein or jugular bulb. Conclusions Variation between organs in cytokine output was observed during experimental sepsis. We see no implication from cytokine levels for initiating protective ventilation before endotoxemia. However, during endotoxemia protective ventilation attenuates hepatic inflammatory cytokine output contributing to a reduced total inflammatory burden.
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Affiliation(s)
- Jesper Sperber
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden. .,Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden. .,Department of Anaesthesiology and Intensive Care, Mälarsjukhuset Eskilstuna, Sweden.
| | - Miklós Lipcsey
- Department of Surgical Sciences, Hedenstierna laboratory, Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
| | - Anders Larsson
- Department of Surgical Sciences, Hedenstierna laboratory, Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
| | - Anders Larsson
- Department of Medical Sciences, Biochemical structure and function, Uppsala University, Uppsala, Sweden.
| | - Jan Sjölin
- Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden.
| | - Markus Castegren
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden. .,Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden. .,Department of Anaesthesiology and Intensive Care, Mälarsjukhuset Eskilstuna, Sweden.
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15
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Lewis SM, Khan N, Beale R, Treacher DF, Brown KA. Depletion of blood neutrophils from patients with sepsis: treatment for the future? Int Immunopharmacol 2013; 17:1226-32. [PMID: 24144812 DOI: 10.1016/j.intimp.2013.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Organ failure arising from severe sepsis accounts for nearly 6 million deaths worldwide per annum. At present there are no specific pharmacological agents available for its treatment and identifying a suitable therapeutic target is urgently needed. Neutrophils appear to be contributing directly to pulmonary damage in severe forms of lung injury and indirectly to the failure of other organs. Blood neutrophils from patients with sepsis possess a phenotype that is indicative of activation and our results show that neutrophils isolated from patients with sepsis exhibit a supranormal adherence to endothelial monolayers treated with pro-inflammatory cytokines. Additional studies reveal that the patients' cells are highly efficient at releasing IL-8. We also demonstrate that organ function is improved upon removing neutrophils from the circulation. In this article we propose that in severe sepsis there is a subpopulation of neutrophils which is actively engaged in pathological insult. The phenotypic characterisation of this subset may provide a novel therapeutic strategy for sepsis that could lead to patient benefit.
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Affiliation(s)
- Sion M Lewis
- Intensive Care Unit, Guy's and St. Thomas' NHS Foundation Trust, London, UK; Vascular Immunology, King's College London, UK
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16
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Barros KV, Cassulino AP, Schalch L, Della Valle Munhoz E, Manetta JA, Calder PC, Flor Silveira VL. Pharmaconutrition: acute fatty acid modulation of circulating cytokines in elderly patients in the ICU. JPEN J Parenter Enteral Nutr 2013; 38:467-74. [PMID: 23471207 DOI: 10.1177/0148607113480183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Enteral supply of ω-3 polyunsaturated fatty acids has been used in an attempt to modulate inflammation and improve outcome in critically ill patients. However, enteral administration may be slow to change membrane composition and therefore may not be the best route to supply these fatty acids in patients with acute conditions. This study evaluated the effects of short-term intravenous (IV) administration of fish oil-based lipid emulsion (FLE) as pharmaconutrition on cytokine levels in critically ill elderly patients. METHODS Enterally fed patients (n = 40; aged 60-80 years) were recruited in the first 48 hours of intensive care unit (ICU) admission. Fifteen patients received IV FLE (0.2 g/kg body weight) over 6 hours for 3 consecutive days, and 25 patients did not receive IV lipid (control). Samples were collected before and 24 hours and 72 hours after the third FLE infusion. Nutrient intakes, clinical parameters, and serum cytokine concentrations were measured. RESULTS Compared with the control, FLE resulted in higher energy intake, lower serum tumor necrosis factor-α and interleukin (IL)-8 concentrations, and higher serum IL-10. These differences occurred around 7-9 days of ICU stay at the time of the patient's extubation. ICU stay, mortality, and markers of coagulation and liver function did not differ between groups. CONCLUSIONS Short-term IV FLE modulates some inflammatory markers in critically ill elderly patients receiving enteral nutrition (EN), suggesting an anti-inflammatory effect. This may be a benefit and suggests a role for FLE administration as a supplement in elderly ICU patients receiving standard EN.
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Affiliation(s)
- Karina V Barros
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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17
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What's new in Shock? December 2012. Shock 2012; 38:575-6. [PMID: 23160519 DOI: 10.1097/shk.0b013e318278ae5f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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