Multicentric experience with interferon gamma therapy in sepsis induced immunosuppression. A case series
Autor: | Anne Claire Lukaszewicz, Claire Dupuis, Valérie Faivre, Jenneke Leentjens, Pierre Tissieres, Caren Brumpt, Peter Pickkers, Didier Payen, Jordi Miatello |
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Přispěvatelé: | Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Endotoxines, Structures et Réponses de l'hôte (ESHR), Département Microbiologie (Dpt Microbio), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS) |
Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Male
0301 basic medicine Lymphocyte medicine.medical_treatment [SDV]Life Sciences [q-bio] lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] Gastroenterology Monocytes Lymphocyte immuno-phenotyping 0302 clinical medicine Interferon gamma Prospective Studies Child Prospective cohort study Aged 80 and over Immunosuppression Middle Aged Interleukin-10 3. Good health Killer Cells Natural Intensive Care Units Infectious Diseases medicine.anatomical_structure Immuno-depression Pseudomonas aeruginosa Cytokines Female SOFA score Research Article medicine.drug Adult medicine.medical_specialty lcsh:Infectious and parasitic diseases Sepsis Interferon-gamma 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center Immune system Internal medicine Immune Tolerance medicine Humans lcsh:RC109-216 Aged Interleukin-6 business.industry Infant 030208 emergency & critical care medicine HLA-DR Antigens Immunotherapy medicine.disease 030104 developmental biology MHC class II business |
Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, BioMed Central, 2019, 19 (1), pp.931. ⟨10.1186/s12879-019-4526-x⟩ BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-10 (2019) BMC Infectious Diseases, 2019, 19 (1), pp.931. ⟨10.1186/s12879-019-4526-x⟩ BMC Infectious Diseases, 19 BMC Infectious Diseases, 19, 1 |
ISSN: | 1471-2334 |
Popis: | Background The sepsis-induced immunodepression contributes to impaired clinical outcomes of various stress conditions. This syndrome is well documented and characterized by attenuated function of innate and adaptive immune cells. Several pharmacological interventions aimed to restore the immune response are emerging of which interferon-gamma (IFNγ) is one. It is of paramount relevance to obtain clinical information on optimal timing of the IFNγ-treatment, −tolerance, −effectiveness and outcome before performing a RCT. We describe the effects of IFNγ in a cohort of 18 adult and 2 pediatric sepsis patients. Methods In this open-label prospective multi-center case-series, IFNγ treatment was initiated in patients selected on clinical and immunological criteria early ( 7 days) following the onset of sepsis. The data collected in 18 adults and 2 liver transplanted pediatric patients were: clinical scores, monocyte expression of HLA-DR (flow cytometry), lymphocyte immune-phenotyping (flow cytometry), IL-6 and IL-10 plasma levels (ELISA), bacterial cultures, disease severity, and mortality. Results In 15 out of 18 patients IFNγ treatment was associated with an increase of median HLA-DR expression from 2666 [IQ 1547; 4991] to 12,451 [IQ 4166; 19,707], while the absolute number of lymphocyte subpopulations were not affected, except for the decrease number of NK cells 94.5 [23; 136] to 32.5 [13; 90.8] (0.0625)]. Plasma levels of IL-6 464 [201–770] to 108 (89–140) ng/mL (p = 0.04) and IL-10 from IL-10 from 29 [12–59] to 9 [1–15] pg/mL decreased significantly. Three patients who received IFNγ early after ICU admission ( Conclusion Guided by clinical and immunological monitoring, adjunctive immunotherapy with IFNγ appears well-tolerated in our cases and improves immune host defense in sepsis induced immuno suppression. Randomized clinical studies to assess its potential clinical benefit are warranted. |
Databáze: | OpenAIRE |
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