Immunoparalysis in patients with severe trauma and the effect of inhaled interferon-gamma
| dc.contributor.author | Nakos, G. | en |
| dc.contributor.author | Malamou-Mitsi, V. D. | en |
| dc.contributor.author | Lachana, A. | en |
| dc.contributor.author | Karassavoglou, A. | en |
| dc.contributor.author | Kitsiouli, E. | en |
| dc.contributor.author | Agnanti, N. | en |
| dc.contributor.author | Lekka, M. E. | en |
| dc.date.accessioned | 2015-11-24T16:39:28Z | |
| dc.date.available | 2015-11-24T16:39:28Z | |
| dc.identifier.issn | 0090-3493 | - |
| dc.identifier.uri | https://olympias.lib.uoi.gr/jspui/handle/123456789/8160 | |
| dc.rights | Default Licence | - |
| dc.subject | immunoparalysis | en |
| dc.subject | human leukocyte antigen-dr | en |
| dc.subject | trauma | en |
| dc.subject | ventilator-associated pneumonia | en |
| dc.subject | interferon-gamma | en |
| dc.subject | platelet-aggregating factor | en |
| dc.subject | phospholipase a(2) | en |
| dc.subject | platelet-aggregating factor acetylhydrolase | en |
| dc.subject | interleukin-10 | en |
| dc.subject | interleukin-1 | en |
| dc.subject | tumor-necrosis-factor | en |
| dc.subject | nosocomial pneumonia | en |
| dc.subject | septic patients | en |
| dc.subject | ifn-gamma | en |
| dc.subject | interleukin-10 | en |
| dc.subject | cell | en |
| dc.subject | prevention | en |
| dc.subject | activation | en |
| dc.subject | infection | en |
| dc.subject | sepsis | en |
| dc.title | Immunoparalysis in patients with severe trauma and the effect of inhaled interferon-gamma | en |
| heal.abstract | Objective: To evaluate the local immune status in patients with severe trauma and the influence of interferon-gamma on patients with immunoparalysis. Patients: Fifty-two mechanically ventilated patients with severe multiple trauma. Setting: A 14-bed polyvalent intensive care unit. Interventions: The local immune status was evaluated by examining bronchoalveolar lavage fluid. Subsequently, the patients were divided into two groups: immunoparalyzed (group 1) and nonimmunoparalyzed (group 2). Immunoparalysis was defined as a decreased level of human leukocyte antigen-DR expression of alveolar macrophages in <30%. Patients with immunoparalysis were treated with 100 Kg of inhaled recombinant human interferon-gamma, three times daily (group 1a, 11 patients) or placebo (group 1b, ten patients). A second bronchoalveolar lavage fluid was obtained 3 days after the initiation of therapy. Measurements: The alterations in human leukocyte antigen-DR expression, as well as in pro- and anti-inflammatory markers, such as platelet-aggregating factor, phospholipase A(2), interleukin-1beta, 0, platelet-aggregating factor acetylhydrolase, and interleukin-10, were evaluated in the bronchoalveolar lavage fluids. Results: In 21 of 52 (40%) patients, immunoparalysis was established. After interferon-gamma administration, the level of human leukocyte antigen-DR expression increased in group 1 a from 17 +/- 5% to 46 +/- 9%. In parallel, platelet-aggregating factor and interleukin-1beta as well as the specific activities of phospholipase A(2) and platelet-aggregating factor acetylhydrolase significantly increased. In contrast, interleukin-10 decreased after interferon-gamma therapy. In group 1 b, no statistically significant changes appeared in the levels of human leukocyte antigen-DR expression or in the concentrations of inflammatory mediators. The incidence of ventilator-associated pneumonia was significantly lower in group la than in group 1 b. The administration of interferon-gamma did not affect the outcome of the patients. Conclusions: A significant proportion of multiply injured patients developed immunoparalysis. The administration of interferon-gamma resulted in the recovery of levels of human leukocyte antigen-DR expression in alveolar macrophages, influenced the inflammatory reaction, and decreased the incidence ventilator-associated pneumonia, without affecting the patients' outcome. | en |
| heal.access | campus | - |
| heal.fullTextAvailability | TRUE | - |
| heal.identifier.secondary | <Go to ISI>://000176841100015 | - |
| heal.journalName | Crit Care Med | en |
| heal.journalType | peer reviewed | - |
| heal.language | en | - |
| heal.publicationDate | 2002 | - |
| heal.publisher | Lippincott, Williams & Wilkins | en |
| heal.recordProvider | Πανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείας | el |
| heal.type | journalArticle | - |
| heal.type.el | Άρθρο Περιοδικού | el |
| heal.type.en | Journal article | en |
Αρχεία
Φάκελος/Πακέτο αδειών
1 - 1 of 1
Φόρτωση...
- Ονομα:
- license.txt
- Μέγεθος:
- 1.74 KB
- Μορφότυπο:
- Item-specific license agreed upon to submission
- Περιγραφή: