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Pathol Biol (Paris). 2011 Dec;59(6):329-33. doi: 10.1016/j.patbio.2011.02.001. Epub 2011 Oct 5.

[Reversing ICU-acquired immunosuppression: an innovative biomarker-guided therapeutic strategy for decreasing sepsis mortality and nosocomial infection rate].

[Article in French]

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  • 1Laboratoire d'Immunologie Cellulaire, Hospices Civils de Lyon, Hôpital E.-Herriot, 5 Place d'Arsonval, 69437 Lyon cedex 03, France. guillaume.monneret@chu-lyon.fr

Abstract

Septic syndromes (systemic inflammatory response associated with infection) remain a major although largely under-recognized health care problem and represent the first cause of mortality in intensive care units. Regarding immune response, it is now agreed that sepsis induces an anti-inflammatory process, acting as a negative feedback. This inhibitory mechanism becomes deleterious as nearly all immune functions are rapidly compromised. The magnitude and persistence over time of this immunosuppression is correlated with nosocomial infections and mortality. Decreased HLA-DR expression on monocytes/increased percentage of regulatory T cells are biomarkers identifying patients at risk who could benefit from immunotherapy. This review attempts to integrate these new facts into an up-to-date account of sepsis pathophysiology.

Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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