Supresorske ćelije mijeloidnog porekla u sekundarnoj sepsi: postoji li povezanost sa smrtnim ishodom?

  • Ivo Udovičić Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Maja Šurbatović Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Goran Rondović Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Ivan Stanojević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Snježana Zeba Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Dragan Djordjević Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Bel gra de, Serbia
  • Ana Popadić Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Snežana Milosavljević Clinical Hospital Center Kosovska Mitrovica, Department of Anesthesiology, Kosovska Mitrovica, Serbia
  • Nikola Stanković Mother And Child Health Care Institute of Serbia „ Dr. Vukan Čupić“, Department of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Džihan Abazović Emergency Medical Centar of Montenegro, Podgorica, Montenegro
  • Danilo Vojvodić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP180706133U
Ključne reči: kostna srž, ćelije, kostna srž, ćelije, supresorske, mortalitet, prognoza, sepsa, lečenje, ishod

Sažetak


Uvod/Cilj. Uloga supresorskih ćelija mijeloidnog porekla (MDSCs) u imunskom odgovoru bolesnika sa sepsom tek treba da bude razjašnjena kod ljudi. Cilj istraživanja je bio da se utvrdi da li kod kritično obolelih sa sekundarnom sepsom i/ili septičkim šokom postoji udruženost učestalosti i/ili apsolutnih brojeva MDSCs sa ishodom bolesti. Metode. U prospektivnu studiju je bilo uključeno ukupno 40 kritično obolelih pacijenata sa sekundarnom sepsom. Detektovane su i kvantifikovane obe glavne podvrste MDSCs: granulocitna (G)-MDSCs i monocitna (M)-MDSCs, po prijemu na bolničko lečenje (prvi dan) i petog dana posle prijema. Primarni ishod je bio bolnički mortalitet. Rezultati. Veća učestalost i apsolutni brojevi subpopulacija koje odgovaraju MDSCs bili su udruženi sa lošim ishodom. Što se relativne kinetike tiče, i kod preživelih i kod umrlih, trajanje sepse od prvog do petog dana bilo je praćeno povećanjem vrednosti MDSCs u obe ispitivane subpopulacije. Multivarijantna logistička regresiona analiza je pokazala da su, za razliku od prvog dana, petog dana the Sequential Organ Failure Assessment (SOFA) skor (OR 2.350; p < 0,05) i frekvenca G-MDSCs (OR 3.575; p < 0,05) bili nezavisni prediktori letalnog ishoda. Zaključak. Ovi nalazi ukazuju na štetnu ulogu MDSCs u sekundarnoj sepsi.

Biografija autora

Ivo Udovičić, Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia

Odsek za lečenje kritično obolelih i povređenih pacijenata, anesteziolog

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Objavljeno
2021/04/08
Broj časopisa
Vol. 77 Br. 8 (2020): Vojnosanit pregl
Rubrika
Originalni članak