Avaliação da expressão de receptores de reconhecimentos e sinalização celular de células do sangue periférico de pacientes séticos e sua relação com desfecho clínico

• Ano de defesa: 2011
• Autor(a) principal: Silva, Selma Cristina da [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Immunophenotyping; Monocytes; Neutrophils; Surface and intracellular receptors; Sepsis; Receptors, Cell Surface; Imunofenotipagem; Monócitos; Neutrófilos; Receptores de superfície celular e intracelular; Sepse; Receptores de Superfície Celular
• Link de acesso: http://repositorio.unifesp.br/handle/11600/9022

Sepsis can be defined as the syndrome of the systemic inflammatory response triggered by a confirmed or suspected infection, where severe sepsis and septic shock are the most serious manifestations. The recognition of these pathogens is done by specific receptors in cells of the innate immune system, which may undergo modulation during the continuum of clinical manifestations of sepsis. The cells responsible for the first line of defense against infections innate immune system are monocytes and neutrophils, which make the recognition of pathogens by Toll like receptors involved in immune response and containment of infection. This study aimed to evaluate the expression of CD14 receptor on monocytes, CD66b and CXCR2 receptors on neutrophils and TLR2, TLR4, TLR5, TLR9 and CD11b on both cellular types of septic patients. Seventy seven (77) septic patients (SP) and 40 healthy volunteers (HV) were included and blood samples were collected on day zero (D0) and after seven days of follow up (D7). The evaluation of the cellular receptors was carried out by flow cytometry. The expression of CD14 on the surface of monocytes (P=0.001) and the expression of CD11B and CXCR2 on the surface of the neutrophils (P=0.007 and P=0.001, respectively) of the SP was lower when compared to HV of was lower in SP when compared with the HV. Conversely, the expression of TLR5 on the surface of monocytes and neutrophils was higher in SP when compared with the HV (P=0.041 and P=0.001, respectively). The expression of TLR2 in the surface of neutrophils (P=0.003) and the expression of TLR5 in the surface of monocytes and neutrophils (P=0.010 and P=0.015, respectively) of SP was lower at the end of the follow up, when compared with the expression of the HV. In addition, the SP that survived showed reduced expression of TLR2 (P=0.001) and TLR4 (P=0.020) in the surface of neutrophils at the end of the follow up. The expression of CXCR2 of those patients that survived was higher at the end of the follow up when compared to the expression at the baseline (P=0.031). In conclusion, the expression of recognition receptors and cell signaling receptors is differently regulated among SP and HV and may reflect the cellular activation during sepsis. In septic patients occurs modulation during the expression of these receptors during follow-up, which for some receptors differed in SP who survived and those who died, suggesting that the pattern of influence adaptation the response inflammatory and evolution of the patients. The expression of recognition receptors and cell signaling is regulated differently in sepsis and may be related to clinical outcome.