儿童热伤害后免疫功能障碍的可逆性
Julia Penatzer1, Pranav Bodempudi1, Dana Schwartz2
1Center for Clinical and Translation Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, United States, 43205.
概括
患有感染的儿科烧伤患者显示免疫功能减弱. 再组合的人类颗粒细胞巨细胞 - 殖民地刺激因子 (GM-CSF) 和瓦利卢马布 (CD27-agonist) 可能会逆转这种免疫抑制.
科学领域:
- 免疫学 免疫学 免疫学
- 儿童烧伤伤害的治疗方法
- 传染性疾病 传染性疾病
背景情况:
- 儿科热损伤导致免疫功能障碍,增加了医院感染 (NI) 的风险.
- 识别有风险的儿科烧伤患者和开发免疫调节疗法对于改善结果至关重要.
- 了解炎症后免疫反应对于预防二次并发症至关重要.
研究的目的:
- 为了研究儿童烧伤患者的免疫功能障碍,这些患者会发展NI.
- 用特定的免疫调节剂评估免疫抑制的活体逆转性.
- 确定用于预测NI风险和潜在治疗目标的生物标志物.
主要方法:
- 分析了141名儿科烧伤患者的免疫功能,比较了那些患有NI的人与那些没有NI的人.
- 测量活体脂多糖 (LPS) 诱导的瘤亡因子α (TNFα) 和植物血凝素 (PHA) 诱导的互白素 (IL) -10的产量.
- 评估免疫细胞比率 (TNFα/CD14+单细胞,IL-10/CD4+淋巴细胞) 和用GM-CSF和varlilumab进行体外治疗.
主要成果:
- 患有NI的患者表现出先天性 (LPS诱导的TNFα) 和适应性 (PHA诱导的IL-10) 免疫功能下降.
- 在患有NI的患者中,特定免疫细胞比率 (LPS-TNFα/CD14+,PHA-IL-10/CD4+) 显著降低.
- 转基因-CSF增加了活体TNFα的产生,而瓦利卢马布增加了IL-10的产生,这表明免疫恢复的潜力.
结论:
- 关键的免疫标记可以识别患有NI风险较高的儿科烧伤患者.
- 再组合的人类颗粒细胞巨细胞 - 殖民地刺激因子 (GM-CSF) 和瓦利卢马布显示出作为活体免疫调节剂的潜力,以恢复烧伤后的免疫功能.
- 使用免疫调节剂的早期干预可以减轻免疫抑制,并减少儿科烧伤患者的NI发生率.
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