In Trauma Patients, the Occurrence of Early-Onset Nosocomial Infections is Associated With Increased Plasma Concentrations of Chromogranin A.

Fiche publication


Date publication

mai 2018

Journal

Shock (Augusta, Ga.)

Auteurs

Membres identifiés du Cancéropôle Est :
Pr ROHR Olivier


Tous les auteurs :
Schneider F, Marban C, Ajob G, Helle S, Guillot M, Launoy A, Maestraggi Q, Scavello F, Rohr O, Metz-Boutigue MH

Résumé

In previously healthy persons suffering from acute illnesses, nosocomial infections (NIs) are frequent. Their prevalence suggests the existence of as yet unknown conditions that may promote care-related infection. This study assessed whether the measurement of plasma chromogranin A, a stress-related protein involved in innate defense, is related to NI risk, and whether any chromogranin A-derived fragment included in vasostatin-I displays immunosuppressive activities related to AP-1 or NF-kappa B downregulation. At the clinical level, trauma patients and healthy controls were recruited to be eligible. Clinical histories were recorded, and standard biological tests (including plasma chromogranin A) were performed. For 9 randomly chosen patients and 16 controls, the time-dependent concentrations of chromogranin A (CGA) were assessed twice a day over 66 h. The data show that trauma patients present a higher value of CGA concentration during 66 h in comparison with healthy controls. In addition, patients maintaining this significant increase in CGA readily develop NIs. We therefore studied the effects of chromogranin A-derived peptides on monocytes, focusing on transcription factors that play a central role in inflammation. In vitro assay demonstrated that a chromogranin A-derived fragment (CGA47-70) displays a significant inhibition of NF-kappa B and AP-1 transcriptional activities in these cells. In conclusion, the occurrence of NI in trauma patients is associated with significantly increased plasma CGA concentrations. Downregulation of the two transcription factors by CGA47-70 might induce early acquired immune defect after a serious medical stress.

Mots clés

Adult, Age of Onset, Chromogranin A, blood, Cross Infection, blood, Female, Humans, Male, Microscopy, Fluorescence, Middle Aged, Peptide Fragments, blood, THP-1 Cells, Wounds and Injuries, blood

Référence

Shock. 2018 05;49(5):522-528