Abstract:
OBJECTIVE:Trauma induces a complex immune response that requires a systems biology research approach. Here, we used a novel technology, mass cytometry by time-of-flight, to comprehensively characterize the multicellular response to trauma. DESIGN:Peripheral blood mononuclear cells samples were stained with a 38-marker immunophenotyping cytometry by time-of-flight panel. Separately, matched peripheral blood mononuclear cells were stimulated in vitro with heat-killed Streptococcus pneumoniae or CD3/CD28 antibodies and stained with a 38-marker cytokine panel. Monocytes were studied for phagocytosis and oxidative burst. SETTING:Single-institution level 1 trauma center. PATIENTS OR SUBJECTS:Trauma patients with injury severity scores greater than 20 (n = 10) at days 1, 3, and 5 after injury, and age- and gender-matched controls. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Trauma-induced expansion of Th17-type CD4 T cells was seen with increased expression of interleukin-17 and interleukin-22 by day 5 after injury. Natural killer cells showed reduced T-bet expression at day 1 with an associated decrease in tumor necrosis factor-β, interferon-γ, and monocyte chemoattractant protein-1. Monocytes showed robust expansion following trauma but displayed decreased stimulated proinflammatory cytokine production and significantly reduced human leukocyte antigen - antigen D related expression. Further analysis of trauma-induced monocytes indicated that phagocytosis was no different from controls. However, monocyte oxidative burst after stimulation increased significantly after injury. CONCLUSIONS:Using cytometry by time-of-flight, we were able to identify several major time-dependent phenotypic changes in blood immune cell subsets that occur following trauma, including induction of Th17-type CD4 T cells, reduced T-bet expression by natural killer cells, and expansion of blood monocytes with less proinflammatory cytokine response to bacterial stimulation and less human leukocyte antigen - antigen D related. We hypothesized that monocyte function might be suppressed after injury. However, monocyte phagocytosis was normal and oxidative burst was augmented, suggesting that their innate antimicrobial functions were preserved. Future studies will better characterize the cell subsets identified as being significantly altered by trauma using cytometry by time-of-flight, RNAseq technology, and functional studies.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Seshadri A,Brat GA,Yorkgitis BK,Keegan J,Dolan J,Salim A,Askari R,Lederer JAdoi
10.1097/CCM.0000000000002577subject
Has Abstractpub_date
2017-09-01 00:00:00pages
1523-1530issue
9eissn
0090-3493issn
1530-0293journal_volume
45pub_type
杂志文章abstract:OBJECTIVES:In this study, we evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subphenotypes using latent class analysis. DESIGN:Prospective coho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004724
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To improve control of blood glucose concentrations in critically ill patients through use of a bedside, nurse-managed, intravenous insulin nomogram. DESIGN:Retrospective, before-after cohort study. SETTING:Fifteen-bed mixed medical/surgical intensive care unit in a tertiary, teaching hospital. PATIENTS:A t...
journal_title:Critical care medicine
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doi:10.1097/00003246-200109000-00010
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abstract:OBJECTIVES:The Fragility Index, which represents the number of patients responsible for a statistically significant finding, has been suggested as an aid for interpreting the robustness of results from clinical trials. A small Fragility Index indicates that the statistical significance of a trial depends on only a few ...
journal_title:Critical care medicine
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doi:10.1097/CCM.0000000000003527
更新日期:2019-03-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000230240.02216.21
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:Regional tidal lung strain may trigger local inflammation during mechanical ventilation, particularly when additional inflammatory stimuli are present. However, it is unclear whether inflammation develops proportionally to tidal strain or only above a threshold. We aimed to 1) assess the relationship between...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000346
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Sepsis and acute lung injury continue to be major causes of morbidity and mortality worldwide despite advances in our understanding of pathophysiology and the discovery of new management strategies. Recent investigations show that stem cells may be beneficial as prognostic biomarkers and novel therapeutic str...
journal_title:Critical care medicine
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doi:10.1097/CCM.0b013e3181f96f5f
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:To determine the blood discard volume, as a multiple of deadspace, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. DESIGN:Prospective, controlled, crossover trial. SETTING:Eighteen-bed intensive care unit of a metropolitan teaching hospital. PATIENTS:A tota...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000063448.98777.EF
更新日期:2003-06-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198405000-00008
更新日期:1984-05-01 00:00:00
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更新日期:2007-11-01 00:00:00
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更新日期:2006-12-01 00:00:00
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更新日期:2000-01-01 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200010000-00001
更新日期:2000-10-01 00:00:00
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journal_title:Critical care medicine
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更新日期:1975-03-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,评审
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更新日期:2008-07-01 00:00:00
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更新日期:2014-03-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198510000-00006
更新日期:1985-10-01 00:00:00
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doi:10.1097/00003246-198511000-00035
更新日期:1985-11-01 00:00:00
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更新日期:2006-12-01 00:00:00
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更新日期:1998-01-01 00:00:00
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更新日期:2014-05-01 00:00:00
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更新日期:2004-09-01 00:00:00
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更新日期:2004-01-01 00:00:00
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更新日期:2019-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:1987-04-01 00:00:00
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更新日期:2009-01-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1998-04-01 00:00:00
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更新日期:2013-05-01 00:00:00