医学
蛛网膜下腔出血
细胞因子
肿瘤坏死因子α
离体
重症监护
髓样
免疫学
内科学
体内
生物
生物技术
重症监护医学
作者
Antoine Roquilly,Cécile Braudeau,Raphaël Cinotti,Erwan Dumonte,Rémi Motreul,Régis Josien,Karim Asehnoune
出处
期刊:PLOS ONE
[Public Library of Science]
日期:2013-08-09
卷期号:8 (8): e71639-e71639
被引量:28
标识
DOI:10.1371/journal.pone.0071639
摘要
Portions of this study were presented at the Annual Congress of Société Française d'Anesthésie et de Réanimation in Paris, September 2012.Toll-like receptor (TLR) agonists are promising therapy for the prevention of nosocomial infections in critical ill patients. We aimed to analyze the TLR-reactivity of circulating dendritic cells (DC) as assessed by cytokine production after an ex vivo challenge with TLR agonists in aneurysmal subarachnoid hemorrhage (SAH) patients.A single-center prospective observational study took place in one intensive care unit of a teaching hospital. Blood samples were harvested on days 2, 5 and 10 in 21 severe SAH patients requiring mechanical ventilation and 17 healthy controls. DC production of cytokines (Tumour Necrosis Factor, TNF-α; Interleukin, IL-12; and Interferon, IFN-α) was assessed by intracellular immunostaining on TLR-3, 4, 7/8 and 9 stimulations. SAH patients had decreased numbers of blood myeloid (mDCs) and plasmacytoid DCs (pDCs) on days 2, 5 and 10. Compared with the healthy controls, the frequency of mDCs producing TNF-α after TLR-3 stimulation was decreased in the SAH patients. The frequency of myeloid DCs producing IL-12 after TLR-3 and 4 stimulations was also decreased in the SAH patients. In contrast, the mDCs response to TLR-7/8 was not impaired in the SAH patients. The frequency of pDCs producing TNF-α(+) and IFN-α(+) on TLR-7/8 stimulation were reduced at all of the tested times in the SAH patients, whereas reactivity to TLR-9 was preserved. On day 2, the pDCs from non-survivor patients (n=8) had a decreased ability to produce IFN-α on TLR-9 stimulation compared with the survivors.These data suggest functional abnormalities of circulating pDCs and mDCs that could be important for immunomodulation after SAH.
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