Deactivation of Alveolar Macrophages in Septic Neutropenic ARDS*

Mokart, Djamel; Guery, Benoît; Bouabdallah, Réda; Martin, Claude; Blache, Jean-Louis; Arnoulet, Christine; Mège, Jean‐Louis

doi:10.1378/chest.124.2.644

Cited by 37 publications

(30 citation statements)

References 46 publications

(42 reference statements)

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“…The reduction in the expression of HLA-DR and co-stimulatory molecules on macrophages would be consistent with an impaired host defense state. 22 We speculate that this state may favor a decreased ability to induce an appropriate acquired immune response to microbial stimuli, which may ultimately perpetuate or promote bacterial colonization within the airways milieu.…”

Section: Discussionmentioning

confidence: 96%

Repetitive organic dust exposure in vitro impairs macrophage differentiation and function

Poole

Alexis

Parks

et al. 2008

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 96%

Repetitive organic dust exposure in vitro impairs macrophage differentiation and function

Poole

Alexis

Parks

et al. 2008

Journal of Allergy and Clinical Immunology

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“…Among the 44 patients who did not survive at day 28, 42 (95%) did not develop neutropenia recovery; this underlines the impact of persistent immunosuppression on outcome [28]. Accordingly, ICU admission of neutropenic cancer patients with ARF during neutropenia recovery is known to be associated with good prognosis [7].…”

Section: Discussionmentioning

confidence: 99%

Prognosis of acute respiratory distress syndrome in neutropenic cancer patients

Mokart¹,

Craenenbroeck²,

Lambert³

et al. 2011

Eur Respir J

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To date, no study has been specifically designed to identify determinants of death in neutropenic cancer patients presenting with acute respiratory distress syndrome (ARDS). The aim of this study was to identify early predictive factors of 28-day mortality in these patients. Factors associated with 28-day mortality during intensive care unit (ICU) stay were also described.70 consecutive cancer patients with ARDS and neutropenia were prospectively analysed over a 6-yr period.Mortality at 28 days was 63%. Factors independently associated with good prognosis were: lobar ARDS (OR 0.10, 95% CI 0.02-0.48), use of initial antibiotic treatment active on difficult to treat bacteria (ticarcillin-resistant Pseudomonas aeruginosa, Stenotrophomonas maltophilia or extended-spectrum b-lactamase-producing strains) (OR 0.08, 95% CI 0.02-0.33) and first-line chemotherapy (OR 0.08, 95% CI 0.02-0.37). During the ICU stay, mortality was associated with the markers of organ dysfunctions, the absence of neutropenia recovery and the use of vasopressors. During the first 3 weeks, the conditional probability of discharge alive from ICU did not decrease.At ICU admission, first-line chemotherapy, lobar ARDS and antibiotic treatment active on difficult-to-treat bacteria were associated with survival. During ICU stay, mortality was associated with organ dysfunctions and use of vasopressors. Most survivors have an ICU stay of .3 weeks.

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“…In such conditions, it has been proposed that activated neutrophils release free radicals, inflammatory mediators, and proteases that can damage lung tissue, leading to flooding of alveoli by plasma liquid and proteins. Conditions such as ARDS have, however, also been reported in severely neutropenic patients (43,44) where alternative mechanisms, such as alveolar macrophage dysfunction (45), have been proposed to contribute to damage of the lung alveolar-capillary barrier. In experimental mouse models of airway inflammation, neutrophil depletion is often associated with attenuation of lung injury (reviewed in Ref.…”

Section: Discussionmentioning

confidence: 99%

Neutrophils Ameliorate Lung Injury and the Development of Severe Disease during Influenza Infection

Tate

Deng

Jones

et al. 2009

The Journal of Immunology

283

308

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The clinical response to influenza infection ranges from mild disease to severe pneumonia and it remains unclear whether the inflammatory response to infection is protective or pathogenic. We have defined a novel role for neutrophils in ameliorating lung injury during influenza infection, thereby limiting development of severe disease. Infection of neutrophil-depleted mice with influenza virus HKx31 (H3N2) led to rapid weight loss, pneumonia, and death. Neutropenia was associated with enhanced virus replication in the respiratory tract; however, viral titers were declining at the time of death, leading us to investigate other factors contributing to mortality. In addition to thymic atrophy, lymphopenia, and viremic spread, depletion of neutrophils led to exacerbated pulmonary inflammation, edema, and respiratory dysfunction. Thus, while it is well established that neutrophils contribute to lung injury in a range of pathological conditions, reduced numbers or impaired neutrophil function can facilitate progression of mild influenza to severe clinical disease.

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Deactivation of Alveolar Macrophages in Septic Neutropenic ARDS*

Cited by 37 publications

References 46 publications

Repetitive organic dust exposure in vitro impairs macrophage differentiation and function

Repetitive organic dust exposure in vitro impairs macrophage differentiation and function

Prognosis of acute respiratory distress syndrome in neutropenic cancer patients

Neutrophils Ameliorate Lung Injury and the Development of Severe Disease during Influenza Infection

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