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Prevention of sepsis by correcting apoptosis
Critical Care volume 17, Article number: P8 (2013)
With the permission of the ethics committee, a controlled, randomized, blind clinical trial included 69 term newborns on mechanical ventilation, without neutropenia and clinical signs of infection, with a content of lymphocytes in early apoptosis (AnnexinV-FITC+PI-) of >9.59%, and in late (AnnexinV-FITC+PI+) of 0.56%. Lymphocytes in apoptosis were detected using antibodies to AnnexinV and propidium iodide staining method of immunophenotyping (flow cytometry; Beckman Coulter Epics XL, USA). The survey was conducted at admission, at 3 to 5 days, and 20 days. The method of random numbers in Group I included 39 newborns who on admission (with written parental consent) received an intravenous infusion of hr-GCSF dose of 10 μg/kg, 3 days. Newborns of Group II (n = 30) did not receive hr-GCSF. Power of the study was 80% (α ≤ 0.05).
For 3 to 5 days, Group I significantly decreased apoptosis of lymphocytes in the early from 16.1% to 7.8%, and in late from 1.3% to 0.1%. The development of sepsis and neutropenia have been reported. We observed no clinical or laboratory signs of adverse effects of the drug. Fatal outcomes (n = 4) are not associated with hr-GCSF, which was confirmed postmortem. Decreased duration of mechanical ventilation (P < 0.05). In Group II, 27 patients at 3 to 5 days developed neutropenia and increased lymphocytes in apoptosis (P < 0.05). Sepsis was diagnosed in 19 children; eight fatal outcomes.
hr-GCSF reduces the incidence of septic complications and one of the mechanisms of its clinical effectiveness is the reduction of apoptotic factors affecting the development of neutropenia.
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Pukhtinskaya MG, Estrin VV, Gulova ES: Clinical and diagnostic value of apoptosis markers in the pathogenesis of neutropenia and bacterial complications in newborns with respiratory distress syndrome. Cytokines Inflamm 2011, 10: 66-69.
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Puhtinskaya, M., Estrin, V. Prevention of sepsis by correcting apoptosis. Crit Care 17, P8 (2013). https://doi.org/10.1186/cc11946
- Mechanical Ventilation
- Propidium Iodide
- Fatal Outcome
- Septic Complication