Group A streptococcal bacteremia: the role of tumor necrosis factor in shock and organ failure.

来自 EBSCO

阅读量：

作者：

DL Stevens，AE Bryant，SP Hackett，A Chang，G Peer，S Kosanke，T Emerson，L Hinshaw

展开

摘要：

Severe group A streptococcal infections associated with early onset of shock and multiorgan failure define the streptococcal toxic shock syndrome. In the United States, group A streptococcal strains most commonly isolated are M types 1 and 3, which produce pyrogenic exotoxin type A. The role of tumor necrosis factor (TNF)-a and the dynamics of cardiovascular and laboratory abnormalities were investigated in a baboon model of group A streptococcal bacteremia that mimics human streptococcal toxic shock syndrome. Profound hypotension, leukopenia, metabolic acidosis, renal impairment, thrombocytopenia, and disseminated coagulopathy developed within 3 h after intravenous infusion of M type 3, pyrogenic exotoxin A-producing group A streptococci. Serum TNF-α peaked at 3 h and returned to baseline by 10 h. Mortality was 100%. Anti-TNF-α monoclonal antibody treatment markedly improved mean arterial blood pressure, tissue perfusion, and survival, suggesting that TNF-α plays an important role in the induction of shock and organ failure in group A streptococcal bacteremia.

展开

关键词：

lymphoma cancer immunotherapy interleukin-2 interleukin-2 receptor T lymphocytes, tumor-infiltrating T lymphocytes, cytotoxic tumor antigens HLA complications capillary leakage