Effect of cytomegalovirus reactivation on the time course of systemic host response biomarkers in previously immunocompetent critically ill patients with sepsis : A matched cohort study

Autor: Van De Groep, K., Nierkens, Stefan, Cremer, Olaf L., Peelen, Linda M., Klein Klouwenberg, Peter M.C., Schultz, Marcus J., Hack, C. Erik, Van Der Poll, Tom, Bonten, Marc J.M., Ong, David S.Y., De Beer, Friso M., Bos, Lieuwe D.J., Glas, Gerie J., Hoogendijk, Arie J., Van Hooijdonk, Roosmarijn T.M., Horn, Janneke, Huson, Mischa A., Juffermans, Nicole P., Schouten, Laura R.A., Scicluna, Brendon, Straat, Marleen, Van Vught, Lonneke A., Wieske, Luuk, Wiewel, Maryse A., Witteveen, Esther, Frencken, Jos F., Koster-Brouwer, Maria E., Varkila, Meri R.J., Verboom, Diana M.
Přispěvatelé: Intensive Care Medicine, Center of Experimental and Molecular Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Critical Illness
Congenital cytomegalovirus infection
Cytomegalovirus
Inflammation
Viremia
Critical Care and Intensive Care Medicine
Cohort Studies
Sepsis
03 medical and health sciences
0302 clinical medicine
medicine
Clinical endpoint
Host response
Humans
030212 general & internal medicine
Critically ill
Aged
Chi-Square Distribution
Interleukin-6
business.industry
Research
Elastase
lcsh:Medical emergencies. Critical care. Intensive care. First aid
virus diseases
030208 emergency & critical care medicine
lcsh:RC86-88.9
Middle Aged
medicine.disease
Reactivation
Immunity
Humoral
Interleukin-10
Chemokine CXCL10
Intensive Care Units
Interleukin 1 Receptor Antagonist Protein
Cytomegalovirus Infections
Immunology
Biomarker (medicine)
Female
Virus Activation
medicine.symptom
Serostatus
business
Biomarkers
Zdroj: Critical Care, 22(1). Springer Science + Business Media
Critical care (London, England), 22(1). Springer Science + Business Media
Critical Care, Vol 22, Iss 1, Pp 1-9 (2018)
Critical Care
ISSN: 1364-8535
Popis: Background Cytomegalovirus (CMV) reactivation in previously immunocompetent critically ill patients is associated with increased mortality, which has been hypothesized to result from virus-induced immunomodulation. Therefore, we studied the effects of CMV reactivation on the temporal course of host response biomarkers in patients with sepsis. Methods In this matched cohort study, each sepsis patient developing CMV reactivation between day 3 and 17 (CMV+) was compared with one CMV seropositive patient without reactivation (CMVs+) and one CMV seronegative patient (CMVs−). CMV serostatus and plasma loads were determined by enzyme-linked immunoassays and real-time polymerase chain reaction, respectively. Systemic interleukin-6 (IL-6), IL-8, IL-18, interferon-gamma–induced protein-10 (IP-10), neutrophilic elastase, IL-1 receptor antagonist (RA), and IL-10 were measured at five time points by multiplex immunoassay. The effects of CMV reactivation on sequential concentrations of these biomarkers were assessed in multivariable mixed models. Results Among 64 CMV+ patients, 45 could be matched to CMVs+ or CMVs− controls or both. The two baseline characteristics and host response biomarker levels at viremia onset were similar between groups. CMV+ patients had increased IP-10 on day 7 after viremia onset (symmetric percentage difference +44% versus −15% when compared with CMVs+ and +37% versus +4% when compared with CMVs−) and decreased IL-1RA (−41% versus 0% and −49% versus +10%, respectively). However, multivariable analyses did not show an independent association between CMV reactivation and time trends of IL-6, IP-10, IL-10, or IL-1RA. Conclusion CMV reactivation was not independently associated with changes in the temporal trends of host response biomarkers in comparison with non-reactivating patients. Therefore, these markers should not be used as surrogate clinical endpoints for interventional studies evaluating anti-CMV therapy. Electronic supplementary material The online version of this article (10.1186/s13054-018-2261-0) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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