Yentis S M, Rowbottom A W, Riches P G
Magill Department of Anaesthetics, Charing Cross & Westminster Medical School, Chelsea & Westminster Hospital, London, UK.
Clin Exp Immunol. 1995 May;100(2):330-5. doi: 10.1111/j.1365-2249.1995.tb03673.x.
Cytokines including IL-1 beta have been implicated in the pathophysiology of sepsis and the systemic inflammatory response. It is believed that certain critically ill patients may be 'primed' with respect to cytokine production, and that subsequent 'triggers' may cause exaggerated cytokine production in these patients with exacerbation of their clinical condition; however, no means of identifying 'primed' patients has been described. The presence of cytoplasmic IL-1 beta within peripheral blood mononuclear cells (PBMC) from patients in the ICU was investigated as a means of identifying 'primed' patients, using fluorescent antibody labelling and flow cytometry. The study revealed that PBMC from ICU patients had a different staining pattern for IL-1 beta than those from healthy subjects, and that PBMC from certain ICU patients did indeed stain strongly for IL-1 beta; however, the presence of these strongly staining cells was not associated with clinical condition or outcome. It is concluded that whilst it might be possible to identify 'primed' patients in the ICU using this technique, this is of no clinical value as a predictor of clinical course.
包括白细胞介素-1β在内的细胞因子与脓毒症的病理生理学及全身炎症反应有关。据信，某些重症患者在细胞因子产生方面可能处于“预激”状态，随后的“触发因素”可能导致这些患者的细胞因子产生过度，临床病情加重；然而，尚未描述识别“预激”患者的方法。作为识别“预激”患者的一种方法，采用荧光抗体标记和流式细胞术研究了重症监护病房（ICU）患者外周血单核细胞（PBMC）中细胞质白细胞介素-1β的存在情况。研究表明，ICU患者的PBMC与健康受试者的PBMC相比，白细胞介素-1β的染色模式不同，某些ICU患者的PBMC确实对白细胞介素-1β染色强烈；然而，这些强染色细胞的存在与临床病情或预后无关。结论是，虽然使用该技术有可能在ICU中识别“预激”患者，但作为临床病程的预测指标，这没有临床价值。
