Transient Bcl-2 gene down-expression in circulating mononuclear cells of severe sepsis patients who died despite appropriate intensive care.
Fiche publication
Date publication
mars 2004
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MEYER Nicolas, Pr OUDET Pierre
Tous les auteurs :
Bilbault P, Lavaux T, Lahlou A, Uring-Lambert B, Gaub MP, Ratomponirina C, Meyer N, Oudet P, Schneider F
Lien Pubmed
Résumé
OBJECTIVE: To assess the levels of expression of the antiapoptotic gene Bcl-2 and the proapoptotic gene Bax in circulating mononuclear cells (CMNC) harvested during the course of severe sepsis (SS) in formerly non-immunocompromised patients undergoing hospital-acquired infection, in parallel to cytokine levels. DESIGN: Prospective study. SETTING: Intensive care unit. PARTICIPANTS: A total of 24 patients without immunodeficiency undergoing standard goal-directed therapy for nosocomial SS, 10 critically ill patients without sepsis, and 10 healthy controls. INTERVENTIONS: Blood was collected before infection and within 12 h, 1, 3 and 7 days after fever onset, to determine plasma concentrations of IL-6, IL-10, TNF-alpha, C-reactive protein, whole blood cell counts, lymphocyte subsets, annexin V labelling for apoptosis, and Bax and Bcl-2 relative RNA expression by real-time polymerase chain reaction. RESULTS: SS patients displayed increased cytokine concentrations, TNF-alpha being significantly increased at full-blown sepsis. Within 12 h after onset of infection, lymphocyte counts were lower in SS patients than in critically ill controls ( p=0.001), and this phenomenon was marked in CD4+ and CD8+ subsets ( p
Référence
Intensive Care Med. 2004 Mar;30(3):408-15