Expression of cell surface receptors and oxidative metabolism modulation in the clinical continuum of sepsis

Background Infection control depends on adequate microbe recognition and cell activation, yet inflammatory response may lead to organ dysfunction in sepsis. the aims of this study were to evaluate cell activation in the context of sepsis and its correlation with organ dysfunction.Methods A total of 41 patients were prospectively enrolled: 14 with sepsis, 12 with severe sepsis and 15 with septic shock. A total of 17 healthy volunteers were included as a control group. Patients were admitted to the Intensive Care Units and Emergency Rooms of Hospital São Paulo ( Federal University of São Paulo) and Hospital Santa Marcelina, São Paulo, Brazil. Toll- like receptor ( TLR) 2, TLR4, CD11b, CD11c and CD66b expression on neutrophil surfaces and oxidative metabolism measured by non- fluorescent dichlorofluorescein ( DCFH) oxidation in neutrophils and monocytes, using whole blood, were evaluated using flow cytometry. Organ dysfunction was measured using the sepsis- associated organ failure assessment ( SOFA) score.Results TLR2 expression on neutrophils was found to be downregulated in septic shock patients compared to healthy volunteers ( p = 0.05). No differences were found in CD11b and CD11c expression. CD66b expression was increased in the patient group compared to the control group ( p = 0.01). Neutrophil and monocyte oxidative burst was increased in septic patients compared to the control group at baseline and after stimulation with phorbol myristate acetate ( PMA), formylmethionylleucyl- phenylalanine ( fMLP), lipopolysaccharide ( LPS) and Staphylococcus aureus ( p 7 was higher than in patients with SOFA scores < 7, both in neutrophils and monocytes. However, oxidative burst in patients with sepsis was as high as in septic shock.Conclusion Surface receptors expression on neutrophils may be modulated across the continuum of sepsis, and enhanced or decreased expression may be found depending on the receptor considered. ROS generation is upregulated both in neutrophils and monocytes in septic patients, and it is differently modulated depending on the stage of the disease and the stimuli used.Universidade Federal de São Paulo, Escola Paulista Med, Div Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Intens Care Unit, São Paulo, BrazilHosp St Marcelina, Intens Care Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Div Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Intens Care Unit, São Paulo, BrazilWeb of Scienc

Most Significant Change in conflict settings: staff development through monitoring and evaluation

Capoeira4Refugees is an NGO that uses the Afro-Brazilian art-form of Capoeira to promote psychosocial well-being in children affected by conflict and occupation. Capoeira4Refugees introduced the Most Significant Change (MSC) methodology to monitor and evaluate project implementation and impact across two locations in the Middle East. Analysis of interviews conducted with five field staff revealed that in line with, and building on previous research, MSC became an empowering tool that led to staff development. The potential for MSC to build staff reflexivity, independence and leadership has implications for other organisations working in conflict areas, particularly in situations of remote management

Spatial heterogeneity in Bayesian disease mapping

© 2018, The Author(s). Disease mapping applications generally assume homogeneous regression effects and use random intercepts to account for residual spatial dependence. However, there may be local variation in the association between disease and area risk factors. We consider implications for model fit, estimated regression coefficients, and substantive inferences of allowing spatial variability in impacts of area risk factors. An application to suicide in 6791 English small areas shows that average regression coefficients and substantive inferences (e.g. about relative risk) may be considerably affected by allowing spatially varying predictor effects, while fit is improved

Evaluation of Toll-like, chemokine, and integrin receptors on monocytes and neutrophils from peripheral blood of septic patients and their correlation with clinical outcomes

Recognition of pathogens is performed by specific receptors in cells of the innate immune system, which may undergo modulation during the continuum of clinical manifestations of sepsis. Monocytes and neutrophils play a key role in host defense by sensing and destroying microorganisms. This study aimed to evaluate the expression of CD14 receptors on monocytes; CD66b and CXCR2 receptors on neutrophils; and TLR2, TLR4, TLR5, TLR9, and CD11b receptors on both cell types of septic patients. Seventy-seven septic patients (SP) and 40 healthy volunteers (HV) were included in the study, and blood samples were collected on day zero (D0) and after 7 days of therapy (D7). Evaluation of the cellular receptors was carried out by flow cytometry. Expression of CD14 on monocytes and of CD11b and CXCR2 on neutrophils from SP was lower than that from HV. Conversely, expression of TLR5 on monocytes and neutrophils was higher in SP compared with HV. Expression of TLR2 on the surface of neutrophils and that of TLR5 on monocytes and neutrophils of SP was lower at D7 than at D0. In addition, SP who survived showed reduced expression of TLR2 and TLR4 on the surface of neutrophils at D7 compared to D0. Expression of CXCR2 for surviving patients was higher at follow-up compared to baseline. We conclude that expression of recognition and cell signaling receptors is differentially regulated between SP and HV depending on the receptor being evaluated

Neutrophil reactive oxygen species (ROS) generation in patients across the continuum of sepsis

ROS generation was measured by 2',7'dichlorofluorescein (DCFH) metabolism. Neutrophils were gated based on FSC versus SSC parameters and the expression of CD14 on cell surface. ROS generation was analyzed in histograms and expressed as the geometric mean fluorescence intensity (GMFI). *p < 0.01 compared to healthy volunteers; #p < 0.05 compared to the severe sepsis group; §p < 0.05 compared to the septic shock group.<p><b>Copyright information:</b></p><p>Taken from "Expression of cell surface receptors and oxidative metabolism modulation in the clinical continuum of sepsis"</p><p>http://ccforum.com/content/12/1/R25</p><p>Critical Care 2008;12(1):R25-R25.</p><p>Published online 13 Feb 2008</p><p>PMCID:PMC2374621.</p><p></p

Correlation between formyl-methionyl-leucyl-phenylalanine (fMLP)-induced reactive oxygen species (ROS) generation and sepsis-associated organ failure assessment (SOFA) score in neutrophils and monocytes in patients with severe sepsis and septic shock

<p><b>Copyright information:</b></p><p>Taken from "Expression of cell surface receptors and oxidative metabolism modulation in the clinical continuum of sepsis"</p><p>http://ccforum.com/content/12/1/R25</p><p>Critical Care 2008;12(1):R25-R25.</p><p>Published online 13 Feb 2008</p><p>PMCID:PMC2374621.</p><p></p