eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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vol. 30

High levels of soluble TNF receptors are related with deficiency of GSH and severity of sepsis in patients with septic infectious endocarditis

Victor Chernyshov
Maxim Vodyanik
Gernot Treusch
Elena Kutsenko

Centr Eur J Immunol 2005; 30 (1-2): 11-16
Online publish date: 2006/07/26
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Background: GSH is a major intracellular antioxidant playing a critical role in the deactivation of toxic compounds as well as in the maintenance of normal immunoreactivity. To reveal interrelations between TNF and GSH, and possible significance of soluble TNF receptors (sTNFRs) as markers of sepsis severity was the aim of present study.
Material and methods: 24 patients with septic infectious endocarditis (Simplified Acute Physiology Score (SAPS) – 7.66±0.52) were monitored before and after surgery, and intensive care procedures. Lymphocyte subsets were studied by flow-cytometry. TNF, sTNFR1 and sTNFR2 were determined in blood plasma samples. Total glutathione and GSH were determined in the whole blood.
Results: Lymphocytopenia with decrease of CD4, CD8 T cells, NK cells, high levels of TNF, sTNFR1 and sTNFR2, low levels of total glutathione and especially GSH, and high levels of oxidized glutathione were detected in septic patients. SAPS indices correlated positively with levels of sTNFR1 and sTNFR2. High negative correlations between GSH levels and sTNFR1, sTNFR2 and TNF were evident. Positive correlations between GSH versus NK cells before and after operation, and between GSH and CD19 cells after operation were found. Valvular surgery and intensive care procedures resulted in improvements of cell counts and their relative percentage.
Conclusion: Septic patients may acquire severe GSH deficiency in part due to the excessive activity of TNF. Restoration of GSH balance may be promising prognostic factor in patients with severe sepsis. Soluble TNF-Rs may reflect the severity of clinical septic cases.

GSH, TNF, soluble TNF-receptors, sepsis

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