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干扰素马驱动的CXCL9的升高:一种新的败血症内型独立与死亡率相关

Evangelos J Giamarellos-Bourboulis¹, Massimo Antonelli², Frank Bloos³

¹4(th) Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Hellenic Institute for the Study of Sepsis, Athens, Greece.

|October 24, 2024

概括

干扰素 (IFNγ) 驱动的败血症 (IDS) 是一种新发现的败血症内型. 这种情况独立地与败血症患者的死亡风险更高有关.

科学领域:

败血症的发病因子和内型鉴定.
免疫学和炎症的研究
关键护理医学关键护理医学

背景情况:

败血症内型的分类对于理解疾病的发病过程至关重要.
巨细胞激活样综合征 (MALS) 和免疫衰竭是已知的败血症内型.
通过组织巨细胞传递的干扰素- (IFNγ) 信号促进了CXCL9化学激素的释放,表明了潜在的新内型.

研究的目的:

调查IFNγ-CXCL9机制是否代表了一个独立的败血症内型.
要定义和描述这种潜在的内型,称为IFNγ驱动性败血症 (IDS).

主要方法:

这是一项大型的队列研究,涉及希腊,德国和意大利的14个患者队列.
队列被随机分为发现 (2/3) 和验证 (1/3) 组.
使用了败血症-3定义;在诊断后24小时内采集血液样本.
测量了IFNγ,CXCL9,IP-10,可溶性CD163和费里的度.
在发现中定义的IDS是由高血IFNγ和高CXCL9设置的,免疫性麻的风险最小.

主要成果:

研究了5503名患者;IDS在败血症病例的19.9% (发现) 和20.0% (验证) 中被确定.
IDS的特点是具有更高的可溶性CD163水平,与MALS不同.
IDS与显著更高的死亡率相关 (43.0%的发现,40.4%的验证).
IDS独立预测死亡,即使经过对其他因素进行调整 (HR 1.71发现,1.70验证).
在72小时内降低IFNγ和CXCL9水平与更好的结果相关.

结论:

IFNγ驱动性败血症 (IDS) 是一种新的和独特的败血症内型.
IDS独立地与不良预后和死亡率增加有关.
这一发现推动了败血症内型的分类,并确定了潜在治疗策略的目标.

关键词:

在CXCL9中使用.干扰素 - 玛的干扰素.巨细胞是一个巨细胞.结果结果的结果.败血症这是一种败血症.

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