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早期固有免疫抑制在鼠严重脓毒症中通过全身性干扰素-β恢复。

Early-phase Innate Immune Suppression in Murine Severe Sepsis Is Restored with Systemic Interferon-β.

机构信息

From the Department of Anesthesiology (Y.K., K.U., T.T., Y.T., H.T., K.H., K.C., Y. Yamada) Department of Acute Medicine (T.H.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan the Discovery Research Department, Pharmaceutical Research and Development Division, Maruishi Pharmaceutical Co., Ltd., Osaka, Japan (Y. Yamamura).

出版信息

Anesthesiology. 2018 Jul;129(1):131-142. doi: 10.1097/ALN.0000000000002185.

Abstract

BACKGROUND

Sepsis is a leading cause of death in the intensive care unit. Immune modulatory therapy targeting sepsis-associated proinflammatory responses has not shown survival benefit. Here, the authors evaluated innate immunity at the early stage of murine mild or severe peritoneal sepsis induced by cecal ligation and puncture, and the effect of systemic interferon-β, a potent inflammatory mediator, on severe sepsis as well as its mechanism of action.

METHODS

Mild and severe sepsis was induced in C57BL/6 mice by cecal ligation and puncture with 22- and 18-gauge needles for puncture, respectively. Interferon-β (700 U/g) was subcutaneously administered either before or 12 h after cecal ligation and puncture for the severe sepsis group.

RESULTS

Severe sepsis resulted in significantly lower 6-day survival rates than mild sepsis (n = 48, 25% vs. n = 11, 81.8%, P = 0.002), significantly less phagocytic capacity of peritoneal exudate cells, and lower CXC chemokine receptor-2 expression on circulating neutrophils at 24 h after cecal ligation and puncture. Interferon-β administration 12 h after cecal ligation and puncture associated with significantly improved survival (n = 34, 52.9%, P = 0.017) increased the number and function of peritoneal exudate cells, peritoneal/systemic inflammatory cytokine/chemokine concentrations, and CXC chemokine receptor-2 on neutrophils, compared with the severe sepsis controls. However, those responses were not observed in the prophylactic interferon-β group (n = 24). Interferon-β increased lipopolysaccharide-induced interleukin-6 messenger RNA/protein expression of lipopolysaccharide-tolerant murine peritoneal macrophages, which was not observed in nontolerant cells.

CONCLUSIONS

In severe sepsis, immune suppression occurs within 24 h and is associated with worse mortality. Interferon-β given after the onset of peritonitis restores impaired innate immunity in vivo and in vitro.

摘要

背景

脓毒症是重症监护病房死亡的主要原因。针对脓毒症相关促炎反应的免疫调节治疗并未显示出生存获益。在这里,作者评估了在盲肠结扎和穿刺诱导的轻度或重度腹膜脓毒症的早期阶段的固有免疫,以及全身性干扰素-β(一种有效的炎症介质)对重度脓毒症的影响及其作用机制。

方法

用 22 号和 18 号针头分别穿刺盲肠来诱导 C57BL/6 小鼠的轻度和重度脓毒症。对于重度脓毒症组,在盲肠结扎和穿刺前或后 12 小时皮下给予干扰素-β(700 U/g)。

结果

重度脓毒症的 6 天存活率明显低于轻度脓毒症(n = 48,25% vs. n = 11,81.8%,P = 0.002),盲肠结扎和穿刺后 24 小时腹膜渗出液细胞的吞噬能力显著降低,循环中性粒细胞上的 CXC 趋化因子受体-2 表达也降低。盲肠结扎和穿刺后 12 小时给予干扰素-β与存活率显著提高相关(n = 34,52.9%,P = 0.017),与重度脓毒症对照组相比,增加了腹膜渗出液细胞的数量和功能、腹膜/全身炎症细胞因子/趋化因子浓度,以及中性粒细胞上的 CXC 趋化因子受体-2。然而,在预防性干扰素-β组(n = 24)未观察到这些反应。干扰素-β增加了脂多糖耐受的小鼠腹膜巨噬细胞中脂多糖诱导的白细胞介素-6 信使 RNA/蛋白表达,但在非耐受细胞中未观察到。

结论

在重度脓毒症中,免疫抑制在 24 小时内发生,与死亡率升高相关。在腹膜炎发作后给予干扰素-β可恢复体内和体外受损的固有免疫。

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