Abstract:
INTRODUCTION:Deregulated apoptosis and overshooting neutrophil functions contribute to immune and organ dysfunction in sepsis and multiple organ failure (MOF). In the present study, we determined the role of soluble Fas (sFas) in the regulation of posttraumatic neutrophil extrinsic apoptosis and the development of sepsis. METHODS:Forty-seven major trauma patients, 18 with and 29 without sepsis development during the first 10 days after trauma, were enrolled in this prospective study. Seventeen healthy volunteers served as controls. Blood samples from severely injured patients were analyzed at day 1, day 5 and day 9 after major trauma. sFas levels, plasma levels of neutrophil elastase (PMNE) and levels of interleukin (IL)-6 were quantified by enzyme-linked immunosorbent assay and related to patients' Sequential Organ Failure Assessment (SOFA) score and Multiple Organ Dysfunction Score (MODS). Neutrophil apoptosis was determined by propidium iodide staining of fragmented DNA and flow cytometry. sFas-mediated effects on neutrophil apoptosis were investigated in cells cultured with agonistic anti-Fas antibodies in the presence of recombinant sFas, sFas-depleted serum or untreated serum from septic patients. RESULTS:Serum levels of sFas in patients who later developed sepsis were significantly increased at day 5 (P < 0.01) and day 9 (P < 0.05) after trauma compared with patients with uneventful recovery. Apoptosis of patient neutrophils was significantly decreased during the observation period compared with control cells. Moreover, Fas-mediated apoptosis of control neutrophils was efficiently inhibited by recombinant sFas and serum from septic patients. Depletion of sFas from septic patient sera diminished the antiapoptotic effects. In septic patients, sFas levels were positively correlated with SOFA at day 1 (r = 0.7, P < 0.001), day 5 (r = 0.62, P < 0.01) and day 9 (r = 0.58, P < 0.01) and with PMNE and leukocyte counts (r = 0.49, P < 0.05 for both) as well as MODS at day 5 (r = 0.56, P < 0.01) after trauma. CONCLUSIONS:Increased sFas in patients with sepsis development impairs neutrophil extrinsic apoptosis and shows a positive correlation with the organ dysfunction scores and PMNE. Therefore, sFas might be a therapeutic target to prevent posttrauma hyperinflammation and sepsis.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Paunel-Görgülü A,Flohé S,Scholz M,Windolf J,Lögters Tdoi
10.1186/cc9965subject
Has Abstractpub_date
2011-01-01 00:00:00pages
R20issue
1eissn
1364-8535issn
1466-609Xpii
cc9965journal_volume
15pub_type
杂志文章相关文献
CRITICAL CARE文献大全abstract::The European Society of Intensive Care Medicine Annual Congress offers the opportunity for basic scientists and clinicians to share recent findings. Apart from the large number of free communications, several sessions of the congress were dedicated to state-of-the-art tutorials given by established speakers. The areas...
journal_title:Critical care (London, England)
pub_type:
doi:10.1186/cc1063
更新日期:2001-12-01 00:00:00
abstract::Fluid resuscitation is a cornerstone of intensive care unit patient care, but prediction of the cardiovascular response remains difficult, despite many efforts in clinical research. The concept of responders and nonresponders illustrates such a difficulty. Many techniques have been tested, from strictly non-invasive t...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc10067
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Prompt diagnosis of candidaemia and invasive candidosis is crucial to the early initiation of antifungal therapy. The poor sensitivity of blood cultures (BCs) has led to the development of fungal glycan tests as a diagnostic adjunct. We analysed the performance of tests for the detection of circulating β-D...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc13953
更新日期:2014-06-29 00:00:00
abstract::High mobility group box protein 1 (HMGB1) has been shown to participate in acute inflammatory reactions, including acute lung injury and sepsis. There is also evidence that circulating levels of HMGB1 are increased after severe trauma and are associated with clinically important outcome parameters, including mortality...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc8141
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Refractory status epilepticus (RSE) secondary to traumatic brain injury (TBI) may be under-recognized and is associated with significant morbidity and mortality. METHODS:This case report describes a 20 year old previously healthy woman who suffered a severe TBI as a result of a motor vehicle collision and...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc3884
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) is common among intensive care unit (ICU) patients. AKI is highly heterogeneous, with variable links to poor outcomes. Current approaches to classify AKI severity and identify patients at highest risk for poor outcomes focus on the maximum change in serum creatinine (SCr) values. Ho...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-016-1546-4
更新日期:2016-11-17 00:00:00
abstract:BACKGROUND:Post-resuscitation hemodynamic instability following out-of-hospital cardiac arrest (OHCA) may occur from myocardial dysfunction underlying cardiogenic shock and/or inflammation-mediated distributive shock. Distinguishing the predominant shock subtype with widely available clinical metrics may have prognosti...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-018-2078-x
更新日期:2018-06-15 00:00:00
abstract:INTRODUCTION:Passive leg raising (PLR) is a simple reversible maneuver that mimics rapid fluid loading and increases cardiac preload. The effects of this endogenous volume expansion on stroke volume enable the testing of fluid responsiveness with accuracy in spontaneously breathing patients. However, this maneuver requ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc8195
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Prognosis in patients suffering out-of-hospital cardiac arrest is poor. Higher survival rates have been observed only in patients with ventricular fibrillation who were fortunate enough to have basic and advanced life support initiated soon after cardiac arrest. An ability to predict cardiac arrest outcome...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7009
更新日期:2008-01-01 00:00:00
abstract::Body cell mass (BCM) is the metabolically active cell mass involved in O₂ consumption, CO₂ production and energy expenditure. BCM measurement has been suggested as a tool for the evaluation of nutritional status. Since BCM is closely related to energy expenditure, it could also represent a good reference value for the...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc13852
更新日期:2014-05-01 00:00:00
abstract:INTRODUCTION:ICU-acquired weakness (ICUAW) complicates the disease course of critically ill patients. Inflammation and acute-phase response occur directly within myocytes and contribute to ICUAW. We observed that tripartite motif-containing 62 (TRIM62), an E3 ubiquitin ligase and modifier of inflammation, is increased ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0545-6
更新日期:2014-09-29 00:00:00
abstract::There are many controversial issues surrounding ethics in study design and conduct of human subjects research. In this review we briefly touch on the origin of ethics in clinical research and how the current regulations and standards came into practice. We then discuss current controversies regarding informed consent,...
journal_title:Critical care (London, England)
pub_type: 历史文章,杂志文章,评审
doi:10.1186/cc5114
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Delayed patient admission to the intensive care unit (ICU) due to lack of bed availability is a common problem, but the effect on patient outcome is not fully known. METHODS:A retrospective study was performed using departmental computerised records to determine the effect of delayed ICU admission and tem...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11650
更新日期:2012-10-01 00:00:00
abstract:INTRODUCTION:A paucity of literature exists regarding delays in transfer out of the intensive care unit. We sought to analyze the incidence, causes, and costs of delayed transfer from a surgical intensive care unit (SICU). METHODS:An IRB-approved prospective observational study was conducted from January 24, 2010, to ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc12807
更新日期:2013-07-04 00:00:00
abstract::There has been a lot of debate about the concept of relative adrenocortical insufficiency (often defined as a reduced response to corticotropin) as a pathophysiological explanation of steroid effects in septic shock. Less is known about the prevalence of absolute adrenocortical insufficiency based on more usual defini...
journal_title:Critical care (London, England)
pub_type: 评论,社论
doi:10.1186/cc6926
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of t...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03396-2
更新日期:2020-12-07 00:00:00
abstract:INTRODUCTION:A lack of data exists in the literature evaluating acidemia on admission as a favorable or negative prognostic factor in patients with acute cardiogenic pulmonary edema (ACPE) treated with non-invasive continuous positive airway pressure (CPAP). The objective of the present study was to investigate the imp...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9315
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:In ARDS patients, changes in respiratory mechanical properties and ventilatory settings can cause incomplete lung deflation at end-expiration. Both can promote dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP). The aim of this study was to investigate, in a large population of ARDS...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-019-2611-6
更新日期:2019-11-27 00:00:00
abstract:BACKGROUND:Electrical impedance tomography (EIT) is a non-invasive bedside tool which allows an individualized ventilator strategy by monitoring tidal ventilation and lung aeration. EIT can be performed at different cranio-caudal thoracic levels, but data are missing about the optimal belt position. The main goal of th...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-1161-9
更新日期:2016-01-08 00:00:00
abstract:INTRODUCTION:Angiopoietin-2 (ang-2), an angiogenic peptide released by endothelial cell Weibel-Palade bodies (WPBs), increases endothelial activation and vascular permeability. Ang-2 is raised in severe sepsis but the mechanisms underlying this are not known. Nitric oxide (NO) inhibits WPB exocytosis, and bioavailabili...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9020
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:The main objective was to determine risk factors for presence of multidrug resistant bacteria (MDR) in postoperative peritonitis (PP) and optimal empirical antibiotic therapy (EA) among options proposed by Infectious Disease Society of America and the Surgical Infection Society guidelines. METHODS:One hun...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc8877
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:The pathophysiology of postoperative delirium remains poorly understood. The purpose of this study was to examine the relationship between serum cortisol level and occurrence of early postoperative delirium in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS:A total of 243 patients...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9393
更新日期:2010-01-01 00:00:00
abstract::This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available f...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-016-1234-4
更新日期:2016-03-16 00:00:00
abstract::Certain noble gases, though inert, exhibit remarkable biological properties. Notably, xenon and argon provide neuroprotection in animal models of central nervous system injury. In the previous issue of Critical Care, Loetscher and colleagues provided further evidence that argon may have therapeutic properties for neur...
journal_title:Critical care (London, England)
pub_type: 评论,信件
doi:10.1186/cc8847
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Functional assessment of arterial load by dynamic arterial elastance (Eadyn), defined as the ratio between pulse pressure variation (PPV) and stroke volume variation (SVV), has recently been shown to predict the arterial pressure response to volume expansion (VE) in hypotensive, preload-dependent patients....
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0626-6
更新日期:2014-11-19 00:00:00
abstract:INTRODUCTION:New technology using partial carbon dioxide rebreathing has been developed to measure cardiac output. Because rebreathing increases respiratory effort, we investigated whether a newly developed system with 35 s rebreathing causes a lesser increase in respiratory effort under partial ventilatory support tha...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc3801
更新日期:2005-10-05 00:00:00
abstract:INTRODUCTION:To systematically review studies evaluating the performance of Sequential Organ Failure Assessment (SOFA)-based models for predicting mortality in patients in the intensive care unit (ICU). METHODS:Medline, EMBASE and other databases were searched for English-language articles with the major objective of ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc7160
更新日期:2008-01-01 00:00:00
abstract::Percutaneous dilatation tracheostomy in the intensive care setting presents an increasingly important concept for establishing a large-bore tracheal airway with minimal surgical intervention. Over the last years, different technical solutions have been studied to assess their respective risks and benefits to determine...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc2968
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:There is increasing interest in the timely administration of concentrated sources of fibrinogen to patients with major traumatic bleeding. Following evaluation of early cryoprecipitate in the CRYOSTAT 1 trial, we explored the use of fibrinogen concentrate, which may have advantages of more rapid administrati...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13054-018-2086-x
更新日期:2018-06-18 00:00:00
abstract::Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-017-1880-1
更新日期:2017-11-19 00:00:00