Non-survivors had higher soluble TREM-1 concentrations http://www.selleckchem.com/products/Nilotinib.html in serum than survivors. In patients with severe AP and in those patients with AP who developed infection, we observed low HLA-DR expression on monocytes and high serum IL-6 concentrations in samples taken at admission and one and three days later. We propose that this pattern could be used to predict the development of severe AP and infection, although further studies are required to confirm this prediction and to determine the appropriate cutoff values. The measurement of HLA-DR expression by flow cytometry is simple and inexpensive, and could be implemented in clinical practice.Key messages? Increased TREM-1 expression on blood monocytes is an indicator of inflammation but not of infection in patients with AP.
? Low HLA-DR expression and high IL-6 concentration could predict severity and infection in samples taken shortly after admission.AbbreviationsAP: acute pancreatitis; APACHE: Acute Physiology and Chronic Health Evaluation; CARS: compensatory anti-inflammatory response syndrome; ELISA: enzyme-linked immunosorbent assay; FITC: fluorescein isothiocyanate; HLA: human leukocyte antigen; IL: interleukin; MFI: mean fluorescence intensity; PAMP: pathogen-associated molecular patterns; PE: phycoerythrin; SIRS: systemic inflammatory response syndrome; TNF: tumor necrosis factor; TREM-1: triggering receptor expressed on myeloid cells-1.Competing interestsThe authors declare that they have no competing interests.Authors’ contributionsEFO, GRD, and AI conceived of the project.
SFF, ADR, GGVG, HRR, and PSF obtained blood samples from patients and followed their clinical evolution. IWB, NEC, and LAP processed the samples. EFO, IWB, RTG, CLM, and AI analyzed the results and wrote the paper.AcknowledgementsThis GSK-3 study was supported financially by Consejo Nacional de Ciencia y Tecnolog��a (CONACyT) (grant no. SALUD-2005-01-13942 to A. Isibasi and SALUD-2004-01-132 to C. L��pez-Mac��as). E. Ferat-Osorio and I. Wong-Baeza received scholarships from CONACyT and I. Wong-Baeza and N. Esquivel-Callejas from IMSS.NotesSee related commentary by Cavaillon, http://ccforum.com/content/13/3/152
Acute kidney injury (AKI) is a common and devastating complication in critically ill burn patients with an incidence reported to be as high as 30% and mortality reported to be between 80 and 100% [1-3]. This AKI-associated mortality appears to be substantially higher in the severely burned than the general ICU population, recently reported to be 60% [4]. Regardless, much as in other critically ill populations, mortality associated with AKI has not improved in this high-risk population over time despite advances in burn care and renal replacement techniques.
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