Toll-like receptor 2 downregulation and cytokine dysregulation predict mortality in patients with Staphylococcus aureus bacteremia
- 주제(키워드) Staphylococcus aureus , Bacteremia , Toll-like receptor 2 (TLR2) , Cytokines
- 주제(기타) Infectious Diseases
- 설명문(일반) [Kim, Nak-Hyun; Choi, Su-Jin; Choe, Pyoeng Gyun; Park, Wan Beom; Kim, Nam-Joong; Oh, Myoung-don] Seoul Natl Univ, Seoul Natl Univ Hosp, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Nak-Hyun; Choi, Yoon Jung; Kim, Moonsuk; Kim, Chung Jong; Song, Kyoung-Ho; Kim, Eu Suk; Kim, Hong Bin] Seoul Natl Univ, Coll Med, Bundang Hosp, Dept Internal Med, 173 Gumi Ro, Seongnam 463707, South Korea; [Sung, Ji Yeon; Park, Kyoung Un] Seoul Natl Univ, Coll Med, Bundang Hosp, Dept Lab Med, Seongnam, South Korea; [Sung, Ji Yeon] Roche Korea, Seoul, South Korea; [Ahn, Soyeon; Ji, Eunjeong] Seoul Natl Univ, Bundang Hosp, Med Res Collaborating Ctr, Seongnam, South Korea; [Kim, Chung Jong] Ewha Womans Univ, Seoul Hosp, Dept Internal Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 BMC
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175165
- 본문언어 영어
- Published As http://dx.doi.org/10.1186/s12879-020-05641-z
- PubMed https://pubmed.ncbi.nlm.nih.gov/33256638
초록/요약
BackgroundStaphylococcus aureus bacteremia (SAB) presents heterogeneously, owing to the differences in underlying host conditions and immune responses. Although Toll-like receptor 2 (TLR2) is important in recognizing S. aureus, its function during S. aureus infection remains controversial. We aimed to examine the association of TLR2 expression and associated cytokine responses with clinical SAB outcomes.MethodsPatients from a prospective SAB cohort at two tertiary-care medical centers were enrolled. Blood was sampled at several timepoints (<= 5 d, 6-9 d, 10-13 d, 14-19 d, and >= 20 d) after SAB onset. TLR2 mRNA levels were determined via real-time PCR and serum tumor necrosis factor [TNF]-alpha, interleukin [IL]-6, and IL-10 levels were analyzed with multiplex-high-sensitivity electrochemiluminescent ELISA.ResultsTLR2 levels varied among 59 SAB patients. On days 2-5, TLR2 levels were significantly higher in SAB survivors than in healthy controls (p=0.040) and slightly but not significantly higher than non-survivors (p=0.120), and SAB patients dying within 7 d had lower TLR2 levels than survivors (P=0.077) although statistically insignificant. IL-6 and IL-10 levels were significantly higher in non-survivors than in survivors on days 2-5 post-bacteremia (P=0.010 and P=0.021, respectively), and those dying within 7 d of SAB (n=3) displayed significantly higher IL-10/TNF-alpha ratios than the survivors did (P=0.007).ConclusionTLR2 downregulation and IL-6 and IL-10 concentrations suggestive of immune dysregulation during early bacteremia may be associated with mortality from SAB. TLR2 expression levels and associated cytokine reactions during early-phase SAB may be potential prognostic factors in SAB, although larger studies are warranted.
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