Occurrence of marked sepsis-induced ...
Document type :
Article dans une revue scientifique
PMID :
Permalink :
Title :
Occurrence of marked sepsis-induced immunosuppression in pediatric septic shock: a pilot study.
Author(s) :
Remy, Solenn [Auteur]
Hôpital Femme Mère Enfant [CHU - HCL] [HFME]
Kolev-Descamps, Karine [Auteur]
Hôpital Femme Mère Enfant [CHU - HCL] [HFME]
Gossez, Morgane [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Venet, Fabienne [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Demaret, Julie [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Javouhey, Etienne [Auteur]
Hôpital Femme Mère Enfant [CHU - HCL] [HFME]
Monneret, Guillaume [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Hôpital Femme Mère Enfant [CHU - HCL] [HFME]
Kolev-Descamps, Karine [Auteur]
Hôpital Femme Mère Enfant [CHU - HCL] [HFME]
Gossez, Morgane [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Venet, Fabienne [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Demaret, Julie [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Javouhey, Etienne [Auteur]
Hôpital Femme Mère Enfant [CHU - HCL] [HFME]
Monneret, Guillaume [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Journal title :
Annals of Intensive Care
Abbreviated title :
Ann. Intensive Care
Volume number :
8
Pages :
36
Publication date :
2018-03-13
Keyword(s) :
Immunosuppression induced
Septic shock
Children
Septic shock
Children
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in children ...
Show more >Background While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyte antigen-DR, mHLA-DR, expression) and adaptive immunity (lymphocyte subsets count), as well as cytokine concentrations (IL-6, IL-8, IL-10, IL-1Ra, TNF-α, IFN-γ). Subsequent objectives were to assess the associations between inflammatory response, potential immunosuppression and secondary acquired infection occurrence. Methods Single-center prospective observational study, including children aged between 1 month and 18 years admitted to pediatric intensive care unit (PICU) for septic shock. Age-matched controls were children hospitalized for elective surgery without any infectious criteria. Blood was sampled at day 1–2, 3–5, and 7–9 after sepsis onset. mHLA-DR and lymphocyte subsets count were measured by flow cytometry and cytokine concentrations by Luminex technology. Results A total of 26 children and 30 controls were included. Patients had lymphopenia, and mHLA-DR levels were significantly lower than controls at each time point (p < 0.0001). All cytokines peaked at day 1–2. Children with secondary acquired infection had lower day 3–5 mHLA-DR and higher pro-inflammatory cytokine concentrations (IL-6, IL-8 and TNF-α) at day 1–2 compared to children without secondary acquired infection. Conclusions The higher initial inflammatory cytokine production was, the more innate immunity was altered, while evaluated by low mHLA-DR expression. Children with decreased mHLA-DR expression developed more secondary acquired infections. Upon confirmation in multicenter cohorts, these results pave the way for immunostimulation for the most immunosuppressed children in order to prevent nosocomial infections in PICU.Show less >
Show more >Background While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyte antigen-DR, mHLA-DR, expression) and adaptive immunity (lymphocyte subsets count), as well as cytokine concentrations (IL-6, IL-8, IL-10, IL-1Ra, TNF-α, IFN-γ). Subsequent objectives were to assess the associations between inflammatory response, potential immunosuppression and secondary acquired infection occurrence. Methods Single-center prospective observational study, including children aged between 1 month and 18 years admitted to pediatric intensive care unit (PICU) for septic shock. Age-matched controls were children hospitalized for elective surgery without any infectious criteria. Blood was sampled at day 1–2, 3–5, and 7–9 after sepsis onset. mHLA-DR and lymphocyte subsets count were measured by flow cytometry and cytokine concentrations by Luminex technology. Results A total of 26 children and 30 controls were included. Patients had lymphopenia, and mHLA-DR levels were significantly lower than controls at each time point (p < 0.0001). All cytokines peaked at day 1–2. Children with secondary acquired infection had lower day 3–5 mHLA-DR and higher pro-inflammatory cytokine concentrations (IL-6, IL-8 and TNF-α) at day 1–2 compared to children without secondary acquired infection. Conclusions The higher initial inflammatory cytokine production was, the more innate immunity was altered, while evaluated by low mHLA-DR expression. Children with decreased mHLA-DR expression developed more secondary acquired infections. Upon confirmation in multicenter cohorts, these results pave the way for immunostimulation for the most immunosuppressed children in order to prevent nosocomial infections in PICU.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Inserm
Université de Lille
CHU Lille
Université de Lille
CHU Lille
Research team(s) :
Immunity, inflammation and fibrsis in auto and allo-reactivity
Submission date :
2019-03-01T14:25:38Z
2024-04-08T07:54:16Z
2024-04-08T07:54:16Z
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