Reil Peter Michael, Maghiar Teodor Traian, Vîlceanu Narcis, Pascalau Andrei, Judea Pusta Claudia Teodora, Marcu Florin, Cavalu Simona, Pop Ovidiu
Klinikum Ingolstadt GmbH, 85049 Ingolstad, Germany.
Department of Morphology Sciences, University of Oradea, 410087 Oradea, Romania.
Diagnostics (Basel). 2022 Mar 23;12(4):781. doi: 10.3390/diagnostics12040781.
Sepsis-induced myocardial dysfunction (SIMD) is one of the major predictors of morbidity and mortality of sepsis. A high percentage of patients with SIMD develop a status similar to cardiogenic shock. A high level of bacterial lipopolysaccharide (LPS) associated with an overexpression of CD14 acts as the trigger for the release of a broad spectrum of cytokines. Our study aimed to understand the correlation between septic cardiomyopathy and CD14 immunohistochemical expression. The study included 29 patients who died of septic shock. Increased values of membranous CD14 and soluble CD14 in the heart tissue were correlated with adverse patient evolution. A high cellular expression of CD14 was noted in the study group vs. the control group ( = 0.0013). Therefore, a close positive association between the amount of LPS related to sCD14 and the cellular expression of mCD14 is probable. By extrapolation, we suggest that a large amount of sCD14 detected in the cardiac tissue will activate the mCD14-TRL4-LBP-LPS complex, which in turn will induce an inadequate immune response, resulting in heart damage proportional to the amount of LPS. CD14 could represent a valuable marker for septic cardiomyopathy; thus, apoptosis of cardiomyocytes could be foreseen by its high value.
脓毒症诱导的心肌功能障碍（SIMD）是脓毒症发病率和死亡率的主要预测指标之一。高比例的SIMD患者会发展为类似于心源性休克的状态。与CD14过度表达相关的高水平细菌脂多糖（LPS）是释放多种细胞因子的触发因素。我们的研究旨在了解脓毒症性心肌病与CD14免疫组化表达之间的相关性。该研究纳入了29例死于脓毒症休克的患者。心脏组织中膜性CD14和可溶性CD14值的升高与患者的不良病情进展相关。与对照组相比，研究组中CD14的细胞表达较高（P = 0.0013）。因此，与sCD14相关的LPS量与mCD14的细胞表达之间可能存在密切的正相关。由此推断，我们认为在心脏组织中检测到的大量sCD14将激活mCD14-TRL4-LBP-LPS复合物，进而诱导免疫反应不足，导致与LPS量成比例的心脏损伤。CD14可能是脓毒症性心肌病的一个有价值的标志物；因此，通过其高值可以预见心肌细胞的凋亡。
