On the verge of using an immune toolbox in the intensive care unit?

Pène, Frédéric; Vincent, Jean‐Louis; Martín‐Loeches, Ignacio

doi:10.1007/s00134-017-4840-y

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…They found that immune monitoring using these two immune biomarkers could be appropriate for the identification of IAI risk in ICU patients. This suggested that immune profiling of critically ill patients can be integrated through a multimodal real-time diagnostic work-up of IAI [77]. Investigating features of the immune response in sepsis, as potential biomarkers, is challenging because of the temporal effects: over time there are differences between patients (interindividual) as well as within the same patient (intraindividual) [78].…”

Section: Elements Of Immunopathogenesis and Molecular Signature Of Se...mentioning

confidence: 99%

Immunomonitoring of Monocyte and Neutrophil Function in Critically Ill Patients: From Sepsis and/or Trauma to COVID-19

Udovičić

Stanojević

Djordjević

et al. 2021

JCM

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Immune cells and mediators play a crucial role in the critical care setting but are understudied. This review explores the concept of sepsis and/or injury-induced immunosuppression and immuno-inflammatory response in COVID-19 and reiterates the need for more accurate functional immunomonitoring of monocyte and neutrophil function in these critically ill patients. in addition, the feasibility of circulating and cell-surface immune biomarkers as predictors of infection and/or outcome in critically ill patients is explored. It is clear that, for critically ill, one size does not fit all and that immune phenotyping of critically ill patients may allow the development of a more personalized approach with tailored immunotherapy for the specific patient. In addition, at this point in time, caution is advised regarding the quality of evidence of some COVID-19 studies in the literature.

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Section: Elements Of Immunopathogenesis and Molecular Signature Of Se...mentioning

confidence: 99%

Immunomonitoring of Monocyte and Neutrophil Function in Critically Ill Patients: From Sepsis and/or Trauma to COVID-19

Udovičić

Stanojević

Djordjević

et al. 2021

JCM

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Permissive underfeeding, cytokine profiles and outcomes in critically ill patients

et al. 2019

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BackgroundDuring critical illness in humans, the effects of caloric restriction on the inflammatory response are not well understood. The aim of this study is to examine the associations of caloric restriction, inflammatory response profiles and outcomes in critically ill patients.MethodsThis is a sub-study of the PermiT trial (Permissive Underfeeding or Standard Enteral Feeding in Critically Ill Adults Trial- ISRCTN68144998). Serum samples were collected on study days 1, 3, 5, 7 and 14 and analyzed for a panel of 29 cytokines. We used principal component analysis to convert possibly correlated variables (cytokine levels) into a limited number of linearly uncorrelated variables (principal components). We constructed repeated measures mixed linear models to assess whether permissive underfeeding compared to standard feeding was associated with difference cytokine levels over time.ResultsA total of 72 critically ill patients were enrolled in this study (permissive underfeeding n = 36 and standard feeding n = 36). Principal component analysis identified 6 components that were responsible for 78% of the total variance. When adjusted to principal components, permissive underfeeding was not associated with 90-day mortality (adjusted odds ratio 1.75, 95% confidence interval 0.44, 6.95, p = 0.43) or with incident renal replacement therapy. The cytokines did not differ with time between permissive underfeeding and standard feeding groups.ConclusionsThe association of permissive underfeeding compared to standard feeding with mortality was not influenced by the inflammatory profile. Permissive underfeeding compared to standard feeding was not associated with differences in the serum levels of cytokines in critically ill patients.

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Cytokine profile in critically ill patients and/or injured persons with secondary sepsis – influence of different pathogens

Djukic,

Pavlovic,

Ilic

et al. 2023

VOJNOSANIT PREGL

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Background/Aim. The role of the complex sepsis-related immune response has not been fully clarified, and still remains a subject matter of investigations. Nowadays, sepsis is considered a dynamic syndrome characterised by many, often antagonistic, phenomena from hyperinflammation to anergy, or immunoparalysis. On the basis of pro- and anti-inflammatory mediators in the critically ill with sepsis, the aim of the study was to determine whether the cytokine profile differs according to the type of bacterial causative agent, as well as to assess the prognostic value regarding the outcome. The outcome measure has been hospital mortality. Methods. Blood serum samples have been taken from 125 critically ill patients with severe secondary sepsis as a consequence of peritonitis, pancreatitis, or trauma, who had been admitted to the surgical intensive care unit (SICU). The average age of the patients was 57.7?17.3. Of the total number of patients, 84 (67,2%) were males, and 41 (32,8%) were females. The levels of pro-inflammatory ? interleukin 1-alpha (IL-1?), IL-1?, IL-6, IL-8, IL-12?70, IL-17?, tumor necrosis factor alpha (TNF?), interferon-gamma (IFN-?), interferon-gamma-inducible protein-10 (IP 10), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein alpha and beta (MIP-1? and MIP-1?), as well as anti-inflammatory mediators IL-4, IL-10, IL-13, IL-27, IL-31 and IL-33 were determined at three time intervals - on the day of admission (the first day), and then on the third and fifth day. Through standard microbiological analyses, the type of the bacterial causative agent has been determined. Results. On the third day of measurement, significant differences in the cytokine levels with regard to the nature of bacteremia were determined in all pro- and anti-inflammatory cytokines, except for IL-8. Generally, the lowest levels were observed in patients with polymicrobial blood culture. On the first and fifth days of measurement, no significant differences in the cytokine levels with regard to the nature of bacteriemia was found. The only significant predictor of the lethal outcome on the first measurement day was IL-17?, AUR ROC of 0,665 (95% confidence interval of 0,519-0,791, ?=0.034) with secondary sepsis as a complication of peritonitis. Conclusion. According to the type of the bacterial causative agent, the lowest levels of cytokines have been observed in patients with the polymicrobial blood culture. IL- 17? is a good predictor of the outcome in patients with peritonitis as an underlying condition of secondary sepsis. The low level of IL-17? in these patients predicted a lethal outcome on the first day of measurement. On the other hand, the levels of other cytokines correlated with the outcome only on the fifth day of measurement, and they were higher in survivors than in non-survivors.

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On the verge of using an immune toolbox in the intensive care unit?

Cited by 3 publications

References 15 publications

Immunomonitoring of Monocyte and Neutrophil Function in Critically Ill Patients: From Sepsis and/or Trauma to COVID-19

Immunomonitoring of Monocyte and Neutrophil Function in Critically Ill Patients: From Sepsis and/or Trauma to COVID-19

Permissive underfeeding, cytokine profiles and outcomes in critically ill patients

Cytokine profile in critically ill patients and/or injured persons with secondary sepsis – influence of different pathogens

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