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Immunoparalysis

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https://www.readbyqxmd.com/read/27894496/postinjury-inflammation-and-organ-dysfunction
#1
REVIEW
Angela Sauaia, Frederick A Moore, Ernest E Moore
The development of organ dysfunction (OD) is related to the intensity and balance between trauma-induced simultaneous, opposite inflammatory responses. Early proinflammation via innate immune system activation may cause early OD, whereas antiinflammation, via inhibition of the adaptive immune system and apoptosis, may induce immunoparalysis, impaired healing, infections, and late OD. Patients discharged with low-level OD may develop the persistent inflammation-immunosuppression catabolism syndrome. Although the incidence of multiple organ failure has decreased over time, it remains morbid, lethal, and resource intensive...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27747458/acute-on-chronic-liver-failure
#2
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27574993/mice-survival-and-plasmatic-cytokine-secretion-in-a-two-hit-model-of-sepsis-depend-on-intratracheal-pseudomonas-aeruginosa-bacterial-load
#3
Damien Restagno, Fabienne Venet, Christian Paquet, Ludovic Freyburger, Bernard Allaouchiche, Guillaume Monneret, Jeanne-Marie Bonnet, Vanessa Louzier
Sepsis is characterized by pro- and anti-inflammatory responses following infection. While inflammation is responsible for widespread organ damage, anti-inflammatory mediators lead to immunoparalysis increasing susceptibility to secondary infections (nosocomial pneumonia). We aimed to investigate the impact of bacterial load on survival and cytokine release in a two-hit murine (C57BL/6J) model of CLP followed by P. aeruginosa pneumonia. Plasmatic TNFα, IL-6, IL-10, sTNFr I and II were quantified until 13 days...
2016: PloS One
https://www.readbyqxmd.com/read/27422251/sepsis-in-cirrhosis-emerging-concepts-in-pathogenesis-diagnosis-and-management
#4
REVIEW
Cyriac Abby Philips, Shiv Kumar Sarin
Infections and sepsis are more common in cirrhotic than in the general population and constitute the commonest cause of sudden worsening and death. The diagnosis of systemic inflammatory syndrome and sepsis are challenging in cirrhotics due to an underlying a state of hyperdynamic circulation. Further, poor nutritional and bone marrow reserves lead to modest host immune response, the so called immunoparalysis state and the outcome of antibiotic therapy is suboptimal. In this review, a comprehensive description of current and emerging concepts in the pathogenesis and diagnosis of sepsis with importance to current and novel biomarkers for diagnosis of sepsis in cirrhosis is presented...
November 2016: Hepatology International
https://www.readbyqxmd.com/read/27398737/potentially-inadvertent-immunomodulation-norepinephrine-use-in-sepsis
#5
Roeland F Stolk, Tom van der Poll, Derek C Angus, Johannes G van der Hoeven, Peter Pickkers, Matthijs Kox
Septic shock is a major cause of death worldwide and a considerable healthcare burden in the twenty-first century. Attention has shifted from damaging effects of the proinflammatory response to the detrimental role of antiinflammation, a phenomenon known as sepsis-induced immunoparalysis. Sepsis-induced immunoparalysis may render patients vulnerable to secondary infections and is associated with impaired outcome. The immunoparalysis hypothesis compels us to reevaluate the current management of septic shock and to assess whether we are inadvertently compromising or altering the host immune response...
September 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27381595/a-three-phase-approach-for-the-early-identification-of-acute-lung-injury-induced-by-severe-sepsis
#6
REVIEW
Tomoharu Miyashita, Ali Karim Ahmed, Shinichi Nakanuma, Koichi Okamoto, Seisho Sakai, Jun Kinoshita, Isamu Makino, Keishi Nakamura, Hironori Hayashi, Katsunobu Oyama, Hidehiro Tajima, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, John W Harmon, Tetsuo Ohta
A number of studies have reported that acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are independent risk factors for organ dysfunction and mortality in patients with sepsis. Although ALI/ARDS might be an essential therapeutic target during the management of sepsis, severe sepsis should be treated effectively and as soon as identified. We have classified three phases, ranging from sepsis to organ dysfunction, characterizing the interaction between neutrophils and platelets. The first phase is neutrophil extracellular trap (NET) formation and intravasated platelet aggregation...
July 2016: In Vivo
https://www.readbyqxmd.com/read/27314598/biological-markers-of-injury-induced-immunosuppression
#7
Christelle Rouget, Thibaut Girardot, Julien Textoris, Guillaume Monneret, Thomas RIMMELé, Fabienne Venet
Severe injuries such as severe sepsis, burn, trauma and major surgery lead to an overlapping development of pro- and anti- inflammatory responses. It is now well established that these injuries are associated with the secondary development of immune suppression, which results in significant morbidity and mortality. Recent data suggest that immunostimulatory drugs might prevent these complications. However, intensive care patients are heterogeneous, making patient stratification essential for a targeted treatment...
June 17, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27309382/past-present-and-future-of-augmentation-of-monocyte-function-in-the-surgical-patient
#8
Norman Galbraith, Samuel Walker, Jane Carter, Hiram C Polk
BACKGROUND: Patients who survive the early phases of major sepsis and trauma can have greater susceptibility to nosocomial infection later. One cause may be impaired monocyte function, which can leave the patient at risk of overwhelming sepsis and multi-organ dysfunction. Efforts to target this immune defect have been fraught with challenges, with many questions unanswered. We summarized the past and current and likely future therapeutic approaches to augmentation of monocyte function in the surgical patient...
October 2016: Surgical Infections
https://www.readbyqxmd.com/read/27290046/long-term-follow-up-of-sepsis-induced-immunoparalysis
#9
M Raja, Hdt Torrance, E R Longbottom, A J Stroud, M E Vivian, P S Zolfaghari, R M Pearse, C J Hinds, M J O'Dwyer
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27289613/immunoparalysis-in-critical-ill-patients-and-its-association-to-nosocomial-and-opportunist-infections-a-preliminary-study
#10
E Villarreal, P Ramirez, L Cordon, P Geffner, A Cortes, M Gordon, E Gonzalez, P Kot, J Ruis, A Sampere
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27132442/-reproduction-of-a-model-of-two-hit-sepsis-model-with-complication-of-pneumonia-in-rat
#11
Yingying Chen, Huixian Li, Shuai Ma, Bo Deng, Jianxin Lu, Feng Ding
OBJECTIVE: To reproduce a clinically relevant "two-hit" model of sepsis complicated by pneumonia and to explore the correlation between "two-hit" and immune state. METHODS: Eighty-one male Sprague-Dawley (SD) rats were divided into groups according to the random number table. Forty-five male rats were assigned respectively to sepsis-alone group, pneumonia 4 days and 7 days after sepsis groups, respectively. Survival rate of each group was observed. Another group of 36 male rats were divided into normal control group, sepsis-alone for 1, 4 and 7 days groups, and sepsis complicated by pneumonia for 4 days and 7 days after sepsis groups, each group consisted of 6 rats...
October 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/27054955/adaptive-immune-function-in-critical-illness
#12
Lesley Doughty
PURPOSE OF REVIEW: This review is being published to update the literature on the function of the adaptive immune system in critical illness, specifically sepsis and acute lung injury. We have focused on the role of T cells in these syndromes. RECENT FINDINGS: The adaptive immune response becomes dysfunctional during sepsis and acute lung injury in very similar ways. Many of the abnormalities contribute to morbidity and mortality. Immunoparalysis captures the breadth of the dysfunction in that T-cell functions are broadly suppressed after the early proinflammatory stages of illness...
June 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27043087/inflammation-and-innate-immune-function-in-critical-illness
#13
Jennifer A Muszynski, Rajan Thakkar, Mark W Hall
PURPOSE OF REVIEW: The purpose of review is to highlight the inflammatory response in critical illness and the importance of immune monitoring and modulation in the diagnosis and treatment of critical illness-induced innate immune suppression. RECENT FINDINGS: The pro and anti-inflammatory responses are known to be concurrently activated in many patients requiring intensive care, with innate immune suppression emerging as an important, and potentially reversible, complication of critical illness...
June 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/26978146/down-regulation-of-microrna-31-in-cd4-t-cells-contributes-to-immunosuppression-in-human-sepsis-by-promoting-th2-skewing
#14
Verena van der Heide, Patrick Möhnle, Jessica Rink, Josef Briegel, Simone Kreth
BACKGROUND: Immunosuppression has been recognized as a major cause of sepsis-related mortality. Currently, there is much interest in identifying central hubs controlling septic immunoparalysis. In this context, in this study, the authors investigate the role of microRNA-31 (miR-31) as a regulator of T cell functions. METHODS: Primary human T cells were separated from healthy volunteers (n = 16) and from sepsis patients by magnetic beads (n = 23). Expression of mRNA/microRNA (miRNA) was determined by real-time polymerase chain reaction...
April 2016: Anesthesiology
https://www.readbyqxmd.com/read/26958709/the-significance-and-challenges-of-monocyte-impairment-for-the-ill-patient-and-the-surgeon
#15
Norman Galbraith, Samuel Walker, Susan Galandiuk, Sarah Gardner, Hiram C Polk
BACKGROUND: Trauma, major elective surgery, and overt sepsis can lead to a cascade of immunological change. A subset of these patients will have a degree of immune suppression that leads to hyporesponsive innate defenses, increasing the risk of infective co-morbidity and death. This article is an overview of monocyte impairment in the high-risk surgical patient. Specifically, our primary focus is on observations made pertaining to monocyte function and pathophysiological mechanisms underpinning this impairment...
June 2016: Surgical Infections
https://www.readbyqxmd.com/read/26950237/broad-defects-in-the-energy-metabolism-of-leukocytes-underlie-immunoparalysis-in-sepsis
#16
Shih-Chin Cheng, Brendon P Scicluna, Rob J W Arts, Mark S Gresnigt, Ekta Lachmandas, Evangelos J Giamarellos-Bourboulis, Matthijs Kox, Ganesh R Manjeri, Jori A L Wagenaars, Olaf L Cremer, Jenneke Leentjens, Anne J van der Meer, Frank L van de Veerdonk, Marc J Bonten, Marcus J Schultz, Peter H G M Willems, Peter Pickkers, Leo A B Joosten, Tom van der Poll, Mihai G Netea
The acute phase of sepsis is characterized by a strong inflammatory reaction. At later stages in some patients, immunoparalysis may be encountered, which is associated with a poor outcome. By transcriptional and metabolic profiling of human patients with sepsis, we found that a shift from oxidative phosphorylation to aerobic glycolysis was an important component of initial activation of host defense. Blocking metabolic pathways with metformin diminished cytokine production and increased mortality in systemic fungal infection in mice...
April 2016: Nature Immunology
https://www.readbyqxmd.com/read/26928303/prolonged-suppression-of-monocytic-human-leukocyte-antigen-dr-expression-correlates-with-mortality-in-pediatric-septic-patients-in-a-pediatric-tertiary-intensive-care-unit
#17
Talita Freitas Manzoli, Eduardo Juan Troster, Juliana Ferreira Ferranti, Maria Mirtes Sales
INTRODUCTION: Immunoparalysis is a syndrome with no clinical symptoms that occurs in some septic patients. Monocytic human leukocyte antigen-DR (mHLA-DR) expression has been used to identify patients in immunoparalysis and prolonged periods of reduced mHLA-DR expression have been correlated with a poor prognosis in sepsis. However, there is a lack of studies investigating mHLA-DR expression in pediatric septic patients. AIM: To determine if mHLA-DR expression correlates with mortality in pediatric septic patients using the QuantiBRITE Anti HLA-DR/Anti-Monocyte,a Bechton Dickinson novel reagent that standardizes flow cytometry values...
June 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/26808636/mitochondrial-dna-an-endogenous-trigger-for-immune-paralysis
#18
Simon T Schäfer, Lars Franken, Michael Adamzik, Beatrix Schumak, André Scherag, Andrea Engler, Niels Schönborn, Jennifer Walden, Susanne Koch, Hideo A Baba, Jörg Steinmann, Astrid M Westendorf, Joachim Fandrey, Thomas Bieber, Christian Kurts, Stilla Frede, Jürgen Peters, Andreas Limmer
BACKGROUND: Critically ill patients are at high risk to suffer from sepsis, even in the absence of an initial infectious source, but the molecular mechanisms for their increased sepsis susceptibility, including a suppressed immune system, remain unclear. Although microbes and pathogen-associated molecular pattern are accepted inducers of sepsis and septic immunosuppression, the role of endogenous Toll-like receptor (TLR) ligands, such as mitochondrial DNA (mtDNA), in altering the immune response is unknown...
April 2016: Anesthesiology
https://www.readbyqxmd.com/read/26529652/effects-of-the-34c-t-variant-of-the-ampd1-gene-on-immune-function-multi-organ-dysfunction-and-mortality-in-sepsis-patients
#19
Bart P Ramakers, Evangelos J Giamarellos-Bourboulis, Chronis Tasioudis, Marieke J H Coenen, Matthijs Kox, Sita H Vermeulen, Johanne M Groothuismink, Johannes G van der Hoeven, Christina Routsi, Athina Savva, Athanassios Prekates, Filia Diamantea, Dimitrios Sinapidis, Paul Smits, Konstantinos Toutouzas, Niels P Riksen, Peter Pickkers
INTRODUCTION: Adenosine exerts anti-inflammatory and tissue-protective effects during systemic inflammation. While the tissue-protective effects might limit organ damage, its anti-inflammatory properties may induce immunoparalysis and impede bacterial clearance. The common 34C>T loss-of-function variant of AMPD1 (rs17602729) is associated with increased adenosine formation, but effects on immune function and outcome in sepsis patients are unknown. METHODS: The effects of the presence of the 34C>T variant on sepsis susceptibility, immune function, multi-organ dysfunction, and mortality in septic patients were studied...
December 2015: Shock
https://www.readbyqxmd.com/read/26379166/interferon-gamma-immunotherapy-in-a-patient-with-refractory-disseminated-candidiasis
#20
Emilie P Buddingh, Jenneke Leentjens, Jasper van der Lugt, Willem A Dik, Mark S Gresnigt, Mihai G Netea, Peter Pickkers, Gertjan J Driessen
Despite advances in supportive care and novel antifungal agents, mortality caused by invasive Candida infection is high. A 3-year-old boy with disseminated Candida dubliniensis infection during induction chemotherapy for acute lymphoblastic leukemia deteriorated despite resolution of neutropenia and appropriate antifungal treatment. Monocyte human leukocyte antigen-DR expression was extremely low, suggesting immunoparalysis. Adjuvant immunotherapy with interferon-gamma restored the immune response, which was accompanied by clinical and radiographic recovery...
December 2015: Pediatric Infectious Disease Journal
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