Volume 18 Supplement 1

34th International Symposium on Intensive Care and Emergency Medicine

Open Access

Study of the ex vivo immune response of polytrauma older patients in the ICU on admission: preliminary results

  • L Filippou1,
  • K Venetsanou1,
  • G Voulalas1,
  • D Markopoulou1,
  • D Chroni1,
  • C Maltezos1 and
  • I Alamanos1
Critical Care201418(Suppl 1):P236

https://doi.org/10.1186/cc13426

Published: 17 March 2014

Introduction

Immunological status is differentiated with age, influencing treatment and outcome [1]. The aim is to determine the immune response of severely traumatized older patients compared with a group with arterial disease, expressed by proinflammatory cytokine release after ex vivo whole-blood LPS stimulation [2].

Methods

The study comprised 16 polytrauma patients admitted to the ICU, aged 78 ± 8 (Group I) and 16 with arterial disease, aged 74 ± 5 (Group II). Ten milliliters of peripheral blood were collected from each patient, divided into two tubes with/without anticoagulant. Diluted 1:10 whole-blood samples were stimulated with 500 pg/ml LPS, at 37°C, for 4 hours. Serum and cell culture supernatants (CCSP) were removed and stored at -70°C. TNFα and IL-6 were measured in serum and CCSP by ELISA.

Results

Serum proinflammatory cytokines were significantly elevated after severe trauma against control group (TNFα, P < 0.001 and IL-6, P < 0.001). Ex vivo cytokine release showed the opposite direction. There was a significantly lower TNFα and IL-6 release for Group I (TNFα, P < 0.05 and IL-6, P < 0.01) compared with Group II. TNFα ex vivo release from the samples of Group II was >300 pg/ml. See Figures 1 and 2.
Figure 1

Serum proinflammatory cytokines in older patients.

Figure 2

Ex vivo proinflammatory cytokine release after whole-blood LPS stimulation in older patients.

Conclusion

Older patients showed adequate immunological response, considering the limit of 300 pg/ml. The incidence of severe trauma was involved in the downregulation of immune activity and should be considered. Group I patients do not have the opportunity to precondition their immune status. Group II patients can better compensate operative therapies.

Authors’ Affiliations

(1)
KAT Hospital Athens

References

  1. Bruno L: Proc Nutr Soc. 1999, 58: 85-98. 10.1079/PNS19990013View ArticleGoogle Scholar
  2. Myrianthefs P, et al.: Cytokine. 2003, 24: 286-292. 10.1016/j.cyto.2003.08.005View ArticlePubMedGoogle Scholar

Copyright

© Filippou et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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