Cell-surface signatures of immune dysfunction risk-stratify critically ill patients: INFECT study
| العنوان: | Cell-surface signatures of immune dysfunction risk-stratify critically ill patients: INFECT study |
|---|---|
| المؤلفون: | Andrew Conway Morris, Alistair I Roy, Ian Dimmick, Alice Wang, Noel L. Warner, Kevin Judge, K. Alun Brown, Jim Keenan, Tony Burpee, Adriano G. Rossi, Deepankar Datta, Timothy S. Walsh, A. John Simpson, Anthony Bateman, Tracey Mare, Manu Shankar-Hari, Christopher J. Weir, Sion M. Lewis, Jean Antonelli, Jillian Rennie, Jacqueline Stephen, Gillian Hulme |
| المساهمون: | Conway Morris, Andrew [0000-0002-3211-3216], Apollo - University of Cambridge Repository |
| المصدر: | Conway Morris, A, Datta, D, Shankar-Hari, M, Stephen, J, Weir, C J, Rennie, J, Antonelli, J, Bateman, A, Warner, N, Judge, K, Keenan, J, Wang, A, Burpee, T, Brown, K A, Lewis, S M, Mare, T, Roy, A I, Hulme, G, Dimmick, I, Rossi, A G, Simpson, A J & Walsh, T S 2018, ' Cell-surface signatures of immune dysfunction risk-stratify critically ill patients: INFECT study ', Intensive Care Medicine, vol. 44, no. 5, pp. 627–635 . https://doi.org/10.1007/s00134-018-5247-0 Intensive Care Medicine |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Original, Neutrophils, Secondary infection, Critical Illness, Critical Care and Intensive Care Medicine, Risk Assessment, Monocytes, Immunophenotyping, 03 medical and health sciences, 0302 clinical medicine, Immune system, Cross infection, Predictive Value of Tests, Internal medicine, Intensive care, Anesthesiology, Sepsis, medicine, Humans, Prospective Studies, Prospective cohort study, Receptor, Anaphylatoxin C5a, Aged, business.industry, 030208 emergency & critical care medicine, Odds ratio, HLA-DR Antigens, Middle Aged, Immunoparesis, T-lymphocytes, regulatory, 3. Good health, Intensive Care Units, 030228 respiratory system, Immune System Diseases, Female, Risk assessment, business, Cohort study |
| الوصف: | Purpose Cellular immune dysfunctions, which are common in intensive care patients, predict a number of significant complications. In order to effectively target treatments, clinically applicable measures need to be developed to detect dysfunction. The objective was to confirm the ability of cellular markers associated with immune dysfunction to stratify risk of secondary infection in critically ill patients. Methods Multi-centre, prospective observational cohort study of critically ill patients in four UK intensive care units. Serial blood samples were taken, and three cell surface markers associated with immune cell dysfunction [neutrophil CD88, monocyte human leucocyte antigen-DR (HLA-DR) and percentage of regulatory T cells (Tregs)] were assayed on-site using standardized flow cytometric measures. Patients were followed up for the development of secondary infections. Results A total of 148 patients were recruited, with data available from 138. Reduced neutrophil CD88, reduced monocyte HLA-DR and elevated proportions of Tregs were all associated with subsequent development of infection with odds ratios (95% CI) of 2.18 (1.00–4.74), 3.44 (1.58–7.47) and 2.41 (1.14–5.11), respectively. Burden of immune dysfunction predicted a progressive increase in risk of infection, from 14% for patients with no dysfunction to 59% for patients with dysfunction of all three markers. The tests failed to risk stratify patients shortly after ICU admission but were effective between days 3 and 9. Conclusions This study confirms our previous findings that three cell surface markers can predict risk of subsequent secondary infection, demonstrates the feasibility of standardized multisite flow cytometry and presents a tool which can be used to target future immunomodulatory therapies. Trial registration The study was registered with clinicaltrials.gov (NCT02186522). Electronic supplementary material The online version of this article (10.1007/s00134-018-5247-0) contains supplementary material, which is available to authorized users. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8321ecd8dba4ce970e3efb1b382ef172 https://www.pure.ed.ac.uk/ws/files/66692113/ConwayMorris2018_Article_Cell_surfaceSignaturesOfImmune.pdf |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....8321ecd8dba4ce970e3efb1b382ef172 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |