The relationship between the degree of malnutrition and changes in selected parameters of the immune response in critically ill patients
| Autor: | Katarzyna Kosałka, Robert Słotwiński, Małgorzata Mikaszewska-Sokolewicz, Marta Stelmasiak, Barbara J. Bałan, Ewelina Szczepanowska, Grzegorz Niewiński |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
stnfr1 Necrosis critically ill Immunology malnutrition Gastroenterology Immune system Internal medicine Intensive care medicine Immunology and Allergy business.industry Interleukin medicine.disease Clinical trial Malnutrition ICU TLR4 innate immune response Medicine Clinical Immunology sTNFR1 medicine.symptom business Homeostasis |
| Zdroj: | Central-European Journal of Immunology Central European Journal of Immunology, Vol 46, Iss 1, Pp 82-91 (2021) |
| ISSN: | 1426-3912 |
| Popis: | Patients treated in intensive care units (ICUs) are at high risk of malnutrition and the resulting homeostasis, metabolic, histological and immunological disorders, especially leading to organ failure and increased susceptibility to infection. In 163 patients with malnutrition [mild in 33 (19.6%), moderate in 69 (42.9%), severe in 61 (37.4%)] treated in the ICU, changes in the concentration of selected proteins [interleukin (IL)-1Ra, tumor necrosis factor (TNF-), soluble tumour necrosis factor receptor-1 (sTNFR1), IL-6, IL-10, sTLR4, MyD88, A20, HSP70, HMGB1] were examined. In the whole group of malnourished patients, median values of sTNFR1, TNF-, IL-6, TLR4, IL-1Ra were significantly increased, while the levels of MyD88 and A20 proteins were significantly reduced (in comparison to the well-nourished healthy group). Only the sTNFR1 protein showed a significant difference between mild, moderate and severe malnutrition, and increased concentrations as the severity of malnutrition increased (the correlation study found that as the degree of malnutrition increased, the sTNFR1 concentrations increased; p = 0.0000, R = 0.5442). It was observed that death was significantly more frequent in the group of patients who on the first day of hospitalization in the ICU scored 5 or more points on the NRS 2002 scale (p = 0.0004). In the patients who died significantly higher concentrations of sTNFR1, IL-6, IL-10, HSP70 were observed in comparison to the patients who survived. The present results are encouraging and indicate the desirability of undertaking multicentre clinical trials including monitoring of sTNFR1 in assessing the severity of malnutrition and immune disorders in the first hours after admission to the ICU, because it can be assumed that without early diagnosis of innate immunity disorders any attempts at their modulation may be ineffective. |
| Databáze: | OpenAIRE |
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