CYTOKINE RESPONSE AND OTHER DIFFERENCES BETWEEN CRITICAL PHASES OF SEPSIS-ASSOCIATED SYSTEMIC INFLAMMATION
https://doi.org/10.15789/1563-0625-2014-2-173-182
Abstract
Acute sepsis (1-3 days after admission) has been compared with tertiary peritonitis, as a clinical variant of prolonged sepsis (7 to 42 days after admission). A total of 153 patients were enrolled into the study, including 112 cases of multiple organ dysfunction syndrome (MODS, as assessed by SOFA score), of them thirty-one with septic shock; fatal outcomes, in 48 cases. Plasma concentrations of C-reactive protein, cytokines (IL-6, IL-8, IL-10, TNFα), cortisol, troponin I, myoglobin, D-dimer were detected by means of immunochemiluminesce assay (ImmuLite). Development of systemic inflammation (SI) was evaluated by appropriate integral criteria. An association was established between SI development and critical complications in the both groups of patients. Meanwhile, hyperergic variants of SI development associated with high cytokine levels, proved to prevail in acute sepsis. On the contrary, hypoergic variants were more common in cases of tertiary peritonitis, being characterized by relatively low levels of cytokines, along with higher probability of other SI syndromes and risks of lethal outcomes. In summary, systemic inflammatory events in acute versus prolonged sepsis may proceed by different pathogenetic pathways.
About the Authors
E. Yu. Gusev
Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, Ekaterinburg
Russian Federation
Russian Federation
PhD, MD (Medicine), Professor, Chief, Laboratory of Inflammation Immunology, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences
N. V. Zotova
Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, Ekaterinburg
Russian Federation
Russian Federation
PhD (Biology), Senior Research Associate, Laboratory of Inflammation Immunology, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences
M. A. Lazareva
Sverdlovsk Regional Clinical Hospital № 1, Ekaterinburg
Russian Federation
Russian Federation
Surgeon, Department of Surgery, Sverdlovsk Regional Clinical Hospital № 1
References
1. Gusev. E.Yu., Yurchenko L.N., Mazurov V.D., Gainanov D.N., Dronishinets N.N. Informatsionnye tekhnologii v meditsine – zatish`e pered burey [Information technologies in medicine – the calm before the storm]. Vek kachestva – Century of Quality, 2005, no. 6, pp. 56-58.
2. Gusev E.Yu, Chereshnev V.A., Yurchenko L.N. Sistemnoe vospalenie s pozitsii teorii tipovogo patologicheskogo protsessa [Systemic inflammation: A theory of a typical pathological process]. Tsitokiny i vospalenie – Cytokines and Inflammation, 2007, vol. 6, no. 4, pp. 9-21.
3. Gusev E.Yu., Yurchenko L.N., Chereshnev V.A., Zotova N.V. Metodologiya izucheniya sistemnogo vospaleniya [A methodology of a study of systemic inflammation]. Tsitokiny i vospalenie – Cytokines and Inflammation, 2008, vol. 7, no. 1, pp. 15-23.
4. Gusev E.Yu., Yurchenko L.N., Chereshnev V.A., Zotova N.V., Zhuravleva Yu.A, Zubova T.E., Rudnov V.A., Kuzmin V.V., Makarova N.P., Leiderman I.N., Levit D.A., Sukhanov V.A., Sipachev A.S., Brazhnikov A.Yu., Reshetnikova S.Yu., Zasorin A.A. Varianty razvitiya ostrogo sistemnogo vospaleniya [Variants of the development of acute systemic inflammation]. Tsitokiny i vospalenie – Cytokines and Inflammation, 2008, vol. 7, no. 2, pp. 9-17.
5. Gusev E.Yu., Zotova N.V., Sipachev A.S. Travma i teoriya sistemnogo vospaleniya [Trauma and the theory of systemic inflammation]. Vestnik anesteziologii i reanimatologii – Journal of Anesthesiology and Intensive Care, 2009, vol. 6, no. 2, pp. 2-10.
6. Gusev E.Yu, Zotova N.V. Sepsis i teoriya sistemnogo vospaleniya [Sepsis and the theory of systemic inflammation]. Klinicheskaya anesteziologiya i reanimatologiya – Clinical Anesthesiology and Intensive Care, 2009, vol. 6, no. 1, pp. 20-28.
7. Gusev E.Yu., Chereshnev V.A. Sistemnoe vospalenie: teoreticheskie i metodologicheskie podkhody k opisaniyu modeli obshchepatologicheskogo protsessa. Chast` 1. Obshchaya kharakteristika protsessa [Systemic inflammation: theoretical and methodological approaches to description of a model of general pathological process. Part I. General characteristic of the process]. Patologiya, fizioliologiya i eksperimental`naya terapiya – Pathology, Physiology and Experimental Therapy, 2012, no. 4, pp. 3-14.
8. Gusev E.Yu., Chereshnev V.A. Evolyutsiya vospaleniya [Evolution of an inflammation]. Tsitokiny i vospalenie – Cytokines and Inflammation, 2012, vol. 11, no. 4, pp. 5-13.
9. Gusev E.Yu., Yurchenko L.N., Chereshnev V.A., Zotova N.V., Kopalova Yu.A. Sposob diagnostiki i prognoza sistemnogo vospaleniya s verifikatsiey faz i stadiy [Tekst] [A method to diagnose and prognoses systemic inflammation with verification phases and stages]. Patent PF 2335771, IPC7 G01N 33/53. Data of publication 10.10.08, Bulletin no. 28, 56 p.
10. Chereshnev V.A., Gaynanov D.N., Arguchinskaya O.N., Yurchenko L.N., Ponikarovskikh A.E., Gusev E.Yu. Sposob postroeniya edinogo informatsionnogo prostranstva dlya prakticheskogo vracha [Tekst] [A method of constructing of unified informational area for physicians]. Patent RF 2299470, IPC7 G06Q 50/00, G06F 17/30, G06F 17/40. Data of publication 20.05.07, Bulletin no. 14, 13 p.
11. Chereshnev V.A., Gusev E.Yu. Immunologicheskie i patofiziologicheskie mekhanizmy sistemnogo vospaleniya [Immunological and pathophysiological mechanisms of systemic inflammation]. Meditsinskaya immunologiya – Medical Immunology, 2012, vol. 14, no. 1–2, pp. 9–20.
12. Bone R.C., Balk R.A., Cerra F.B., Dellinger R.P., Fein A.M., Knaus W.A., Schein R.M., Sibbald W.J. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest., 1992, vol. 101, no. 6, pp. 1644-1655.
13. Buijk S.E., Bruining H.A. Future directions in the management of tertiary peritonitis. Intensive Care Med., 2002, vol. 28, no. 8, pp. 1024-1029.
14. Malangoni M.A. Evaluation and management of tertiary peritonitis. Am. Surg., 2000, vol. 66, no. 2, pp. 157-161.
15. Nathens A.B., Rotstein O.D., Marshall J.C. Tertiary peritonitis: clinical features of a complex nosocomial infection. World J. Surg., 1998, vol. 22, no. 2, pp. 158-163
Review
For citations:
Gusev E.Yu., Zotova N.V., Lazareva M.A. CYTOKINE RESPONSE AND OTHER DIFFERENCES BETWEEN CRITICAL PHASES OF SEPSIS-ASSOCIATED SYSTEMIC INFLAMMATION. Medical Immunology (Russia). 2014;16(2):173-182. (In Russ.) https://doi.org/10.15789/1563-0625-2014-2-173-182
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