Systemic Inflammatory Response Syndrome After Major Abdominal Surgery Predicted by Early Upregulation of TLR4 and TLR5
| Autor: | Andrew J. Stagg, R. Lahiri, Michael J. O’Dwyer, Edward M. Giles, Hew D.T. Torrance, Alastair O’Brien, Satyajit Bhattacharya, Zora Bashir, William Alazawi, Graham R. Foster, Yannick Derwa, Helen C. Owen |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Blood transfusion medicine.medical_treatment Gastroenterology Monocytes Sepsis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Internal medicine Abdomen Humans Medicine Prospective Studies Interleukin 6 Prospective cohort study Eritoran Aged Aged 80 and over biology Interleukin-6 business.industry Interleukin Middle Aged Flow Cytometry medicine.disease Immunity Innate Systemic Inflammatory Response Syndrome Up-Regulation Toll-Like Receptor 4 Systemic inflammatory response syndrome Toll-Like Receptor 5 030104 developmental biology chemistry 030220 oncology & carcinogenesis Immunology biology.protein Female Surgery business Biomarkers Abdominal surgery |
| Zdroj: | Annals of Surgery. 263:1028-1037 |
| ISSN: | 0003-4932 |
| Popis: | OBJECTIVES\ud \ud To study innate immune pathways in patients undergoing hepatopancreaticobiliary surgery to understand mechanisms leading to enhanced inflammatory responses and identifying biomarkers of adverse clinical consequences.\ud \ud BACKGROUND\ud \ud Patients undergoing major abdominal surgery are at risk of life-threatening systemic inflammatory response syndrome (SIRS) and sepsis. Early identification of at-risk patients would allow tailored postoperative care and improve survival.\ud \ud METHODS\ud \ud Two separate cohorts of patients undergoing major hepatopancreaticobiliary surgery were studied (combined n = 69). Bloods were taken preoperatively, on day 1 and day 2 postoperatively. Peripheral blood mononuclear cells and serum were separated and immune phenotype and function assessed ex vivo.\ud \ud RESULTS\ud \ud Early innate immune dysfunction was evident in 12 patients who subsequently developed SIRS (postoperative day 6) compared with 27 who did not, when no clinical evidence of SIRS was apparent (preoperatively or days 1 and 2). Serum interleukin (IL)-6 concentration and monocyte Toll-like receptor (TLR)/NF-κB/IL-6 functional pathways were significantly upregulated and overactive in patients who developed SIRS (P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|