TY - JOUR
TI - The level of endotoxemia in sepsis varies in relation to the underlying infection: Impact on final outcome
AU - Kritselis, I.
AU - Tzanetakou, V.
AU - Adamis, G.
AU - Anthopoulos, G.
AU - Antoniadou, E.
AU - Bristianou, M.
AU - Kotanidou, A.
AU - Lignos, M.
AU - Polyzos, K.
AU - Retsas, T.
AU - Sassopoulou, P.
AU - Papaioannou, A.I.
AU - Sinapidis, D.
AU - Sereti, K.
AU - Vittoros, V.
AU - Ghanas, P.
AU - Gogos, C.
AU - Giamarellos-Bourboulis, E.J.
JO - Immunology Letters
PY - 2013
VL - 152
TODO - 2
SP - 167-172
PB - Elsevier
SN - 0165-2478
TODO - 10.1016/j.imlet.2013.05.013
TODO - antiinfective agent;  lipopolysaccharide;  tumor necrosis factor alpha;  lipopolysaccharide;  tumor necrosis factor alpha, abdominal infection;  acute cholecystitis;  adaptive immunity;  adult;  aged;  article;  bacteremia;  blood sampling;  cell isolation;  community acquired pneumonia;  controlled clinical trial;  controlled study;  cytokine release;  disease association;  disease severity;  endotoxemia;  enzyme immunoassay;  ex vivo study;  female;  Gram negative bacterium;  human;  immunopathogenesis;  incubation time;  infection;  inflammation;  innate immunity;  kinetics;  Limulus lysate test;  major clinical study;  male;  monocyte;  mortality;  multicenter study;  outcome assessment;  peritonitis;  priority journal;  prospective study;  protein blood level;  sepsis;  shock;  supernatant;  survivor;  urinary tract infection;  ventilator associated pneumonia;  blood;  clinical trial;  endotoxemia;  Gram negative infection;  immunology;  mononuclear cell;  pneumonia;  sepsis, Aged;  Endotoxemia;  Female;  Gram-Negative Bacterial Infections;  Humans;  Leukocytes, Mononuclear;  Lipopolysaccharides;  Male;  Pneumonia;  Prospective Studies;  Sepsis;  Tumor Necrosis Factor-alpha
TODO - Former studies of our group have shown that the innate and adaptive immune status may differ in relation with the causative infection. To this same end, it was investigated if kinetics of circulating lipopolysaccharide (LPS) leading to inflammatory response may differ. Blood was sampled from 189 patients with sepsis and 206 with severe sepsis/shock starting 24. h from advent of sepsis and repeating on day 3. Serum LPS was measured by Limulus Amebocyte Lysate (LAL) assay. From 59 patients, circulating monocytes were isolated and incubated in the absence/presence of LPS. Concentrations of tumor necrosis factor-alpha (TNFα) were measured in supernatants by an enzyme immunoassay. In either category of severity, circulating LPS was greater among sufferers from primary Gram-negative bacteremia (BSI) and from community-acquired pneumonia (CAP) than sufferers from other underlying infections. LPS were greater among patients with BSI compared to patients with secondary Gram-negative bacteremia and patients without bacteremia. Greater decrease of circulating LPS over 48. h was recorded for survivors compared to non-survivors only within sufferers from BSI and CAP. Significant endotoxemia was considered for patients with serum LPS within the upper quartile of distribution; their monocytes were less potent for release of TNFα. It is concluded that endotoxemia in sepsis varies greatly with the underlying infection; this is related with immunoparalysis of monocytes with implications on final outcome. © 2013 Elsevier B.V.
ER -