Serial increase of IL-12 response and human leukocyte antigen-DR expression in severe sepsis survivors 英文参考文献.docVIP

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Serial increase of IL-12 response and human leukocyte antigen-DR expression in severe sepsis survivors 英文参考文献.doc

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Serial increase of IL-12 response and human leukocyte antigen-DR expression in severe sepsis survivors 英文参考文献

Wuetal.CriticalCare2011,15:R224 /content/15/5/R224 RESEARCH OpenAccess SerialincreaseofIL-12responseandhuman leukocyteantigen-DRexpressioninsevere sepsissurvivors Huang-PinWu1,2*,Chi-ChungShih2,3,Chun-YaoLin1,Chung-ChingHua1andDuen-YauChuang4 Abstract Introduction:Sepsis-inducedimmunosuppressionmayresultindeath.Themechanismsofimmunesuppression includelossofmacrophageandmonocyteexpressionofthemajorhistocompatibilitycomplex,increasedanti- inflammatorycytokineexpressionanddecreasedexpressionofproinflammatorycytokines.Inthisstudy,wesought todeterminethemechanismsofimmunesuppressioninseveresepsisbyrepeateddetection. Methods:Wedesignedthisprospectiveobservationalstudytomeasuremonocytehumanleukocyteantigen (HLA)-DRexpression,plasmacytokinelevelsandcytokineresponsesondays1and7instimulatedperipheralblood mononuclearcells(PBMCs)ofhealthycontrolsandpatientswithseveresepsis. Results:Ofthe35enrolledpatients,23survivedfor28daysand12died,6ofwhomdiedwithin7days.Plasma levelsofIL-1b,IL-6,IL-10,IL-17,transforminggrowthfactor(TGF)-b1andTNF-awerehigher,butplasmaIL-12level waslowerinsepticpatientsthanthoseincontrols.Day1plasmalevelsofIL-1b,IL-6,IL-10andTGF-b 1in nonsurvivorswerehigherthanthoseinsurvivors.Day7plasmaIL-10levelsinnonsurvivorswerehigherthanin survivors.IL-1bresponsewashigher,butIL-12andTNF-aresponseswerelowerinsepticpatientsthanincontrols. Day1IL-6responsewaslower,butday1TGF-b1responsewashigherinnonsurvivorsthaninsurvivors.PlasmaIL- 6andIL-10levelsweredecreasedinsurvivorsafter6days.IL-6responsewasdecreasedinsurvivorsafter6days, butIL-12responsewasincreased.Monocytepercentagewashigher,butpositiveHLA-DRpercentageinmonocytes andmeanfluorescenceintensity(MFI)ofHLA-DRwerelowerinsepticpatientsthanincontrols.MFIofHLA-DR wasincreasedinsurvivorsafter6days. Conclusions:MonocyteHLA-DRexpressionandIL-12responsefromPBMCsarerestoredinpatientswhosurvive severesepsis. Keywords:interleukin12,interleukin6,humanleukocyteantigen-DR,peripheralbloodmononuclearcells,severe sepsis Introduction t