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活着的败血症患者的内型与功能性检测证明了活跃的免疫反应

Adam D Price¹, Ellen R Becker¹, Evan L Barrios²

¹Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Frontiers in immunology

|October 29, 2024

概括

功能性免疫反应,如瘤亡因子 (TNF) 表达,可以预测败血症患者的结果. 早期的"免疫能力"免疫内型表明毒症患者的生存率和出院倾向更好.

科学领域:

免疫学免疫学免疫学
临界护理医学临界护理医学
翻译研究是翻译研究.

背景情况:

败血症涉及复杂而异质的免疫反应,传统上使用静态指标进行评估.
需要新的方法来动态评估败血症中的免疫功能,以改善患者分层和治疗.

研究的目的:

测试ex vivo功能性瘤坏死因子 (TNF) 表达和免疫内型是否可以模拟败血症患者的临床结果.
研究特定免疫内型 (基于IFNγ和TNF) 与患者的生存率和出院倾向之间的关联.

主要方法:

一项前性观察性研究,涉及107名败血症患者,68名非败血症ICU患者和46名健康对照.
全血ELISpot测定量出体TNF和IFNγ表达在ICU入院后的1,4和7天.
患者被分为四种免疫内型:"免疫能力强"",免疫抑制"和两个"混合"类别.

主要成果:

活体TNF表达量的增加与败血症患者的良好出院和较低的住院死亡率相关.
"免疫能力"的内型与"免疫抑制"的内型相比,与更好的出院倾向和更高的住院生存率有关.
总TNF和IFNγ表达的减少与败血症患者的180天死亡率增加有关.

结论:

功能性TNF表达的ex vivo评估可以作为败血症临床结果的有价值的预测指标.
早期识别"免疫能力"的免疫内型预测了更好的存活率和出院成功.
败血症患者的功能性免疫分层可能会指导针对性免疫调节疗法的开发.

关键词:

在IL-6的研究中,IL-6被认为是IL-6的基因.危急的疾病危急的疾病.晚期死亡率晚期死亡率预测建模预测建模这是什么意思? procalcitonin.

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