Group A Streptococcal Bacteremia: The Role of Tumor Necrosis Factor in Shock and Organ Failure
| Autor: | Sean P. Hackett, Stanley D. Kosanke, Amy E. Bryant, Dennis L. Stevens, T. Emerson, Chang Ak, Lerner B. Hinshaw, G. Peer |
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| Rok vydání: | 1996 |
| Předmět: |
Male
Streptococcus pyogenes Multiple Organ Failure Bacteremia medicine.disease_cause Group A Streptococcal Infections medicine Animals Humans Immunology and Allergy Leukopenia Tumor Necrosis Factor-alpha Streptococcus business.industry Hemodynamics Antibodies Monoclonal Metabolic acidosis medicine.disease Shock Septic Disease Models Animal Infectious Diseases Shock (circulatory) Immunology Female medicine.symptom business Multiple organ dysfunction syndrome Exotoxin Papio |
| Zdroj: | Journal of Infectious Diseases. 173:619-626 |
| ISSN: | 1537-6613 0022-1899 |
| DOI: | 10.1093/infdis/173.3.619 |
| Popis: | Severe group A streptococcal infections associated with early onset shock and multiorgan failure define the streptococcal toxic shock syndrome. In the United States, group A streptococcal strains most commonly isolated are M types 1 and 3, which produce pyrogenic exotoxin type A. The role of tumor necrosis factor (TNF)-alpha and the dynamics of cardiovascular and laboratory abnormalities were investigated in a baboon model of group A Streptococcal bacteremia that mimics human Streptococcal toxic shock syndrome. Profound hypotension, leukopenia, metabolic acidosis, renal impairment, thrombocytopenia, and disseminated coagulopathy developed within 3 h after intravenous infusion of M type 3, pyrogenic exotoxin A-producing group A streptococci. Serum TNF-alpha peaked at 3 h and returned to baseline by 10 h. Mortality was 100%. Anti-TNF-alpha monoclonal antibody treatment markedly improved mean arterial blood pressure, tissue perfusion, and survival, suggesting that TNF-alpha plays an important role in the induction of shock and organ failure in group A streptococcal bacteremia. |
| Databáze: | OpenAIRE |
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