Exploratory Evaluation of the Relationship Between iNKT Cells and Systemic Cytokine Profiles of Critically Ill Patients with Neurological Injury.

摘要: BACKGROUND Neurological injury can alter the systemic immune system, modifying functional capacity of cells and causing a dysfunctional balance cytokines, although mechanisms remain incompletely understood. The objective this study was to assess temporal relationship between changes in activation status circulating invariant natural killer T (iNKT) plasma cytokines among critically ill patients with neurological injury. METHODS We conducted an exploratory prospective observational adult (18 years or older) intensive care unit (ICU) acute (n = 20) compared ICU without (n = 22) healthy controls (n = 10). Blood samples were collected on days 1, 2, 4, 7, 14, 28 following admission analyze iNKT by flow cytometry concentration inflammation-relevant mediators, including helper 1 (TH1) 2 (TH2) multiplex bead-based assay. RESULTS Invariant activated both patient groups controls. had decreased levels multiple TH1 (interferon-γ, tumor necrosis factor-α, interleukin-12p70), indicative immunosuppression. This led greater than twofold increase ratio TH2/TH1 early after (days 1 - 2) controls, shift that also observed for Systemic cytokine ratios positively associated cell negatively These relationships strongest CD4+ subset CD4- subset. individual similarly differed groups. Forty percent developed infection; however, differences infection subgroup not identified. CONCLUSIONS Critically demonstrated altered profiles injury, association peripheral elevated ratios. work provides further support brain-immune axis ability have far-reaching effects body's system.