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Titolo:
CD14 expression on monocytes and TNF alpha production in patients with septic shock, cardiogenic shock or bacterial pneumonia
Autore:
de Werra, I; Zanetti, G; Jaccard, C; Chiolero, R; Schaller, MD; Yersin, B; Glauser, MP; Calandra, T; Heumann, D;
Indirizzi:
CHU Vaudois, Div Malad Infect, Dept Infect Dis, CH-1011 Lausanne, Switzerland CHU Vaudois Lausanne Switzerland CH-1011 , CH-1011 Lausanne, Switzerland CHU Vaudois, Dept Surg Intens Care, CH-1011 Lausanne, Switzerland CHU Vaudois Lausanne Switzerland CH-1011 , CH-1011 Lausanne, Switzerland CHU Vaudois, Dept Med Intens Care, CH-1011 Lausanne, Switzerland CHU Vaudois Lausanne Switzerland CH-1011 , CH-1011 Lausanne, Switzerland CHU Vaudois, Dept Emergency, CH-1011 Lausanne, Switzerland CHU Vaudois Lausanne Switzerland CH-1011 , CH-1011 Lausanne, Switzerland
Titolo Testata:
SWISS MEDICAL WEEKLY
fascicolo: 3-4, volume: 131, anno: 2001,
pagine: 35 - 40
SICI:
1424-7860(20010127)131:3-4<35:CEOMAT>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
CYTOKINE PRODUCTION; BLOOD MONOCYTES; DOWN-REGULATION; WHOLE-BLOOD; LIPOPOLYSACCHARIDE; SEPSIS; LPS; RECOGNITION; MECHANISMS; ACTIVATION;
Keywords:
cytokines; TNF alpha; septic shock; LPS; cardiogenic shock; pneumonia; CD14;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Heumann, D CHU Vaudois, Div Malad Infect, Dept Infect Dis, BH19, CH-1011 Lausanne, Switzerland CHU Vaudois BH19 Lausanne Switzerland CH-1011 nne, Switzerland
Citazione:
I. de Werra et al., "CD14 expression on monocytes and TNF alpha production in patients with septic shock, cardiogenic shock or bacterial pneumonia", SWISS MED W, 131(3-4), 2001, pp. 35-40

Abstract

Objectives: In patients with septic shock, circulating monocytes become refractory to stimulation with microbial products. Whether this hyporesponsive e state is induced by infection or is related to shock is unknown. To address this question, we measured TNF alpha production by monocytes or by whole blood obtained from healthy volunteers (controls), from patients with septic shock, from patients with severe infection (bacterial pneumonia) without shock, and from patients with cardiogenic shock without infection. Measurements: The numbers of circulating monocytes, of CD14+ monocytes, and the expression of monocyte CD14 and the LPS receptor, were assessed by flow cytometry. Monocytes or whole blood were stimulated with lipopolysaccharide endotoxin (LPS), heat-killed Escherichia roll or Staphylococcus aureus,and TNF alpha production uas measured by bioassay:Results: The number of circulating monocytes, of CD14+ monocytes, and the monocyte CD14 expression were significantly lon er in patients with septic shock than in controls, in patients with bacterial pneumonia or in those with cardiogenic shock (p <0.001). Monocytes or whole blood of patients with septic shock exhibited a profound deficiency of TNFa production in responseto all stimuli (p <0.05 compared to controls). Whole blood of patients with cardiogenic shock also exhibited this defect (p <0.05 compared to controls), although to a lesser extent, despite normal monocyte counts and normal CD14 expression. Conclusion: Unlike patients with bacterial pneumonia, patients with septicor cardiogenic shock display profoundly defective TNF<alpha> production inresponse to a broad range of infectious stimuli. Thus, down-regulation of cytokine production appears to occur in patients with systemic, but not localised, albeit severe, infections and also in patients with non-infectious circulatory failure. Whilst depletion of monocytes and reduced monocyte CD14 expression are likely to be critical components of the hyporesponsivenessobserved in patients with septic shock, other as yet unidentified factors are at work in this group and in patients with cardiogenic shock.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 22:41:26