Abstract
Among the immunological events, apoptosis plays an important role in sepsis. Inhibition of apoptosis in mouse models of sepsis improved survival [1]. Phosphatidyl serin externalisation has been detected in peripheral blood leukocytes of patients suffering from sepsis as an early stage of apoptosis [2,3]. It has not been shown if they undergo complete apoptosis. Therefore, the aim of the current study was to examine if circulating lymphocytes of septic patients display DNA degradation as a sign of late apoptosis. Isolated mononuclear cells of 11 critically ill patients (three with severe sepsis) were compared with eight healthy controls. Phosphatydil serin externalisation was evaluated by annexin V binding. Necrotic cells were excluded by propidium iodine stain. DNA fragmentation was detected by TUNEL staining using flow cytometry. In critically ill patients annexin binding was increased to 12.1 ± 7.5% compared with a basal population of 3.8 ± 0.9% in healthy controls (P < 0.05). The TUNEL-positive population increased from 0.5 ± 0.1% to 2.3 ± 1.5% in critically ill patients (P < 0.05). The study demonstrates that mononuclear cells of critically ill patients show signs of early apoptosis and to a lesser degree also signs of DNA fragmentation. This may be explained by rapid clearing of phosphatydil serin expressing cells from the circulation by phagocytosis.
Highlights
Activation of the HPA axis occurs in order to control potentially deleterious effects of systemic inflammation during sepsis
A recent study showed that vascular endothelial damage was the primary cause of multiple organ failure (MOF) in patients with thrombopenia and that humoral mediators played a major role in the development of this process [1]
We aimed to evaluate the relation between the platelet counts (PC), the C-reactive protein and plasma fibrinolytic capacity in intensive care unit (ICU) patients
Summary
Activation of the HPA axis occurs in order to control potentially deleterious effects of systemic inflammation during sepsis. The aim of the study was to evaluate the effects of PEEP on intrathoracic blood volumes and cardiac function measured by the COLD system in ARDS patients. The objective was to identify risk factors and outcome of pregnant women who required intensive care This pilot study aims to find stress (S) and other personality traits (physical symptoms [PS], anger [A]) among the ICU staff, and any existing correlation between them and length of working time (LWT) in the ICU and with educational level (EDL). The role of Drotrecogin alfa (activated) (recombinant human activated protein C [rhAPC]) in modulating microvascular coagulation through the inhibition of thrombin generation has been well studied in experimental and clinical settings of severe sepsis, little is known about its direct anti-inflammatory effects on vascular endothelial cells. The aim is to determine whether an effective lifestyle adaptation program post CABG could enhance the quality of life of the CABG patient
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