Balance Between the Proinflammatory and Anti-Inflammatory Immune Responses with Blood Transfusion in Sepsis

Rice, Teresa C.; Pugh, Amanda M.; Caldwell, Charles C.; Schneider, Barbara

doi:10.1016/j.cnc.2017.04.003

Cited by 14 publications

(15 citation statements)

References 58 publications

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“…As we did not tell apart invasive and non-invasive ventilation and the duration of ventilation was not recorded, the result should be interpreted cautiously. The association between blood transfusion and secondary infection of sepsis could be induced by transfusion-related immune modulation (TRIM) caused by the altered immune function [35][36][37][38]. However, transfusion was not found to be an independent risk factor in our study and it could be affected by type and quantity of transfusion.…”

Section: Discussioncontrasting

confidence: 63%

Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

Chen

Zhang

et al. 2019

Preprint

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Background: Secondary infection in hospital was found to have a higher incidence in septic patients and affect clinical outcomes. This study aimed to investigate the clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis. Methods: A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between 2014 January and 2018 January. Data were acquired from medical records. The flow cytometry was performed to measure the CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression. Serum cytokines levels were measured by enzyme-linked immunosorbent assay (ELISA) method. Results: A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 38, 32%). Urinary and deep venous catheterization increased the risk of developing secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital length of stay owing to secondary infection was 4.63 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival curves and Log-rank test revealed secondary infection group had a worse survival between day 15 and day 90. Conclusions: Urinary and deep venous catheter indwelling increased the risk of developing secondary infection. Secondary infection influenced outcomes of septic patients and prolonged in-hospital length of stay. Immunosuppression led to a higher tendency to developing secondary infection. Keywords: Sepsis, Secondary infection, Immunosuppression, HLA-DR, Cytokine

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Section: Discussioncontrasting

confidence: 63%

Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

Chen

Zhang

et al. 2019

Preprint

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“…It’s also proved by previous studies that the need for mechanical ventilation of critical ill patients incurred high prevalence of ventilator-associated pneumonia, which accounted for nearly half of nosocomial infections [3, 4, 37]. Blood transfusion was also a potential risk factor due to the effect of transfusion-related immune modulation (TRIM) as reveal by previous studies [38–41]. Nevertheless, mechanical ventilation and blood transfusion were only found to be risk factors in univariate analysis of our study, but not multivariate analysis.…”

Section: Discussionmentioning

confidence: 81%

Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study

Yao

Zhang

et al. 2019

BMC Anesthesiol

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Background Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis. Methods A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively. Results A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 ± 1.87 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival analysis and Log-rank test revealed that secondary infection group had worse survival between day 15 and day 90. Conclusions Urinary and deep venous catheterization increased the risk of secondary infection, in which underlying immunosuppression might also play a role. Secondary infection affected the prognosis of septic patients and prolonged in-hospital length of stay.

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“…Under normal conditions, pro-inflammatory and antiinflammatory cytokines are in a dynamic balance at very low levels, thereby ensuring homeostasis. However, when sepsis occurs, a large number of pro-inflammatory and anti-inflammatory factors are released, leading to imbalance between the two factors, organ dysfunction and inflammatory damage to tissue cells [10,11].…”

Section: Discussionmentioning

confidence: 99%

Protective effect of astragalus injection against myocardial injury in septic young rats via inhibition of JAK/STAT signal pathway and regulation of inflammation

Zhao¹,

Wang²,

Li³

et al. 2020

Trop. J. Pharm Res

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Purpose: To investigate the protective effect of astragalus injection against myocardial injury in septic young rats, and the underlying mechanism of action. Methods: Seventy-two healthy Sprague Dawley (SD) rats were randomly selected and used to establish a young rat model of sepsis. The young rats were randomly divided into 3 groups: sham, model and astragalus injection groups. Each group had 24 young rats. Serum cardiac troponin I (cTnI), IL-10, IL-6, JAK2 and STAT3 were measured after op. Results: Compared with sham group, serum cTnI level in the model group was significantly higher, while serum cTnI level of the drug group was significantly lower than that of the model group (p < 0.05). Compared with model group, the level of IL-10 in the myocardial tissue of the drug group was significantly elevated, while IL-6 level was lower (p < 0.05). Relative to sham rats, myocardial JAK2 and STAT3 protein levels in model rats were high. However, myocardial JAK2 and STAT3 proteins in the drug-treated rats were significantly downregulated, relative to model rats (p < 0.05). Conclusion: Astragalus injection upregulates IL-10 and IL-6 in rats by inhibiting the activation of JAK/STAT signal pathway, and via maintenance of pro-inflammation/anti-inflammation balance. Thus, astragalus exerts protective effect against myocardial injury in sepsis, and can potentially be developed for use as such in clinical practice. Keywords: Astragalus injection, JAK/STAT signal pathway, Pro-inflammatory/anti-inflammatory imbalance, Sepsis, Myocardial injury

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Balance Between the Proinflammatory and Anti-Inflammatory Immune Responses with Blood Transfusion in Sepsis

Cited by 14 publications

References 58 publications

Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study

Protective effect of astragalus injection against myocardial injury in septic young rats via inhibition of JAK/STAT signal pathway and regulation of inflammation

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