Plasma levels of danger-associated molecular patterns are associated with immune suppression in trauma patients

Intensive Care Medicine
Kim TimmermansP Pickkers

Abstract

Danger-associated molecular patterns (DAMPs) released of trauma could contribute to an immune suppressed state that renders patients vulnerable towards nosocomial infections. We investigated DAMP release in trauma patients, starting in the prehospital phase, and assessed its relationship with immune suppression and nosocomial infections. Blood was obtained from 166 adult trauma patients at the trauma scene, emergency room (ER), and serially afterwards. Circulating levels of DAMPs and cytokines were determined. Immune suppression was investigated by determination of HLA-DRA gene expression and ex vivo lipopolysaccharide-stimulated cytokine production. Compared with healthy controls, plasma levels of nuclear DNA (nDNA) and heat shock protein-70 (HSP70) but not mitochondrial DNA were profoundly increased immediately following trauma and remained elevated for 10 days. Plasma cytokines were increased at the ER, and levels of anti-inflammatory IL-10 but not of pro-inflammatory cytokines peaked at this early time-point. HLA-DRA expression was attenuated directly after trauma and did not recover during the follow-up period. Plasma nDNA (r = -0.24, p = 0.006) and HSP70 (r = -0.38, p < 0.0001) levels correlated negatively with HLA-DRA ex...Continue Reading

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Citations

Feb 26, 2016·Intensive Care Medicine·Karim AsehnouneGuillaume Monneret
Oct 21, 2016·Intensive Care Medicine·Rebecca M KochPeter Pickkers
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Methods Mentioned

BETA
PCR
ELISA
PCA
ISS
flow cytometry

Clinical Trials Mentioned

NCT01835457

Software Mentioned

SPSS
Graphpad Prism
Python

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