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
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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