败血症
免疫系统
免疫抑制
基因表达谱
微阵列
免疫学
全血
医学
免疫失调
基因表达
感染性休克
基因
淋巴细胞
生物
遗传学
作者
Grant P Parnell,Benjamin Tang,Marek Nalos,Nicola J. Armstrong,Stephen Huang,David R. Booth,Anthony S. McLean
出处
期刊:Shock
[Ovid Technologies (Wolters Kluwer)]
日期:2013-09-01
卷期号:40 (3): 166-174
被引量:89
标识
DOI:10.1097/shk.0b013e31829ee604
摘要
There is currently no reliable tool available to measure immune dysfunction in septic patients in the clinical setting. This proof-of-concept study assesses the potential of gene expression profiling of whole blood as a tool to monitor immune dysfunction in critically ill septic patients. Whole-blood samples were collected daily for up to 5 days from patients admitted to the intensive care unit with sepsis. RNA isolated from whole-blood samples was assayed on Illumina HT-12 gene expression microarrays consisting of 48,804 probes. Microarray analysis identified 3,677 genes as differentially expressed across 5 days between septic patients and healthy controls. Of the 3,677 genes, biological pathway analysis identified 86 genes significantly downregulated in the sepsis patients were present in pathways relating to immune response. These 86 genes correspond to known immune pathways implicated in sepsis, including lymphocyte depletion, reduced T-lymphocyte activation, and deficient antigen presentation. Furthermore, expression levels of these genes correlated with clinical severity, with a significantly greater degree of downregulation found in nonsurvivors compared with survivors. The results show that whole-blood gene expression analysis can capture systemic immune dysfunctions in septic patients. Our study provides an experimental basis to support further study on the use of a gene expression-based assay, to assess immunosuppression, and to guide immunotherapy in future clinical trials.
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