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. 2015;40(3):311-24.
doi: 10.5114/ceji.2015.54593. Epub 2015 Oct 15.

Innate immunity gene expression changes in critically ill patients with sepsis and disease-related malnutrition

Robert Słotwiński  1 , Agnieszka Sarnecka  2 , Aleksandra Dąbrowska  3 , Katarzyna Kosałka  3 , Ewelina Wachowska  3 , Barbara J Bałan  3 , Marta Jankowska  3 , Teresa Korta  4 , Grzegorz Niewiński  4 , Andrzej Kański  4 , Małgorzata Mikaszewska-Sokolewicz  5 , Mohammad Omidi  6 , Krystyna Majewska  6 , Sylwia M Słotwińska  7
Affiliations

Innate immunity gene expression changes in critically ill patients with sepsis and disease-related malnutrition

Robert Słotwiński et al. Cent Eur J Immunol. 2015.

Abstract

The aim of this study was an attempt to determine whether the expression of genes involved in innate antibacterial response (TL R2, NOD 1, TRAF6, HMGB 1 and Hsp70) in peripheral blood leukocytes in critically ill patients, may undergo significant changes depending on the severity of the infection and the degree of malnutrition. The study was performed in a group of 128 patients with infections treated in the intensive care and surgical ward. In 103/80.5% of patients, infections had a severe course (sepsis, severe sepsis, septic shock, mechanical ventilation of the lungs). Clinical monitoring included diagnosis of severe infection (according to the criteria of the ACC P/SCC M), assessment of severity of the patient condition and risk of death (APACHE II and SAPS II), nutritional assessment (NRS 2002 and SGA scales) and the observation of the early results of treatment. Gene expression at the mRNA level was analyzed by real-time PCR. The results of the present study indicate that in critically ill patients treated in the IC U there are significant disturbances in the expression of genes associated with innate antimicrobial immunity, which may have a significant impact on the clinical outcome. The expression of these genes varies depending on the severity of the patient condition, severity of infection and nutritional status. Expression disorders of genes belonging to innate antimicrobial immunity should be diagnosed as early as possible, monitored during the treatment and taken into account during early therapeutic treatment (including early nutrition to support the functions of immune cells).

Keywords: gene expression; innate immunity; malnutrition; sepsis.

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Figures

Fig. 1A-D
Fig. 1A-D
Expression of genes encoding TLR2, HMGB1, Hsp70 and NOD1 proteins in patients without severe septic infections (1) compared with patients with severe infections (2) (*p < 0.05)
Fig. 2A-D
Fig. 2A-D
Expression of genes encoding TLR2, TRAF6, HMGB1 and Hsp70 proteins in patients with severe malnutrition (1) compared to patients with moderate malnutrition (2) (*p < 0.05)
Fig. 3A,B
Fig. 3A,B
Expression of genes encoding TLR2 and NOD1 proteins in patients with moderate malnutrition (1) compared to patients with mild malnutrition or normal nutritional status (2) (*p < 0.05)
Fig. 4
Fig. 4
Expression of TLR2, NOD1, TRAF6, HMGB1 and Hsp 70 genes in deceased patients with severe malnutrition (A) compared with patients with normal nutritional status or mild malnutrition (B) (*p < 0.05)
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