What caused lymphopenia in SARS and how reliable is the lymphokine status in glucocorticoid-treated patients?
Identifieur interne : 001C79 ( Main/Exploration ); précédent : 001C78; suivant : 001C80What caused lymphopenia in SARS and how reliable is the lymphokine status in glucocorticoid-treated patients?
Auteurs : N S Panesar [Hong Kong]Source :
- Medical hypotheses [ 0306-9877 ] ; 2008.
Descripteurs français
- KwdFr :
- Axe hypophyso-surrénalien (métabolisme), Cytokines (métabolisme), Glucocorticoïdes (usage thérapeutique), Humains, Hydrocortisone (métabolisme), Hypothalamus (métabolisme), Lymphocytes (métabolisme), Lymphokines (métabolisme), Lymphopénie (), Lymphopénie (virologie), Lymphopénie (étiologie), Modèles biologiques, Modèles théoriques, Pronostic, Syndrome respiratoire aigu sévère (), Syndrome respiratoire aigu sévère (sang), Syndrome respiratoire aigu sévère (traitement médicamenteux), Système immunitaire.
- MESH :
- métabolisme : Axe hypophyso-surrénalien, Cytokines, Hydrocortisone, Hypothalamus, Lymphocytes, Lymphokines.
- sang : Syndrome respiratoire aigu sévère.
- traitement médicamenteux : Syndrome respiratoire aigu sévère.
- usage thérapeutique : Glucocorticoïdes.
- virologie : Lymphopénie.
- étiologie : Lymphopénie.
- Humains, Lymphopénie, Modèles biologiques, Modèles théoriques, Pronostic, Syndrome respiratoire aigu sévère, Système immunitaire.
English descriptors
- KwdEn :
- Cytokines (metabolism), Glucocorticoids (therapeutic use), Humans, Hydrocortisone (metabolism), Hypothalamus (metabolism), Immune System, Lymphocytes (metabolism), Lymphokines (metabolism), Lymphopenia (complications), Lymphopenia (etiology), Lymphopenia (virology), Models, Biological, Models, Theoretical, Pituitary-Adrenal System (metabolism), Prognosis, Severe Acute Respiratory Syndrome (blood), Severe Acute Respiratory Syndrome (complications), Severe Acute Respiratory Syndrome (drug therapy).
- MESH :
- chemical , metabolism : Cytokines, Hydrocortisone, Lymphokines.
- chemical , therapeutic use : Glucocorticoids.
- blood : Severe Acute Respiratory Syndrome.
- complications : Lymphopenia, Severe Acute Respiratory Syndrome.
- drug therapy : Severe Acute Respiratory Syndrome.
- etiology : Lymphopenia.
- metabolism : Hypothalamus, Lymphocytes, Pituitary-Adrenal System.
- virology : Lymphopenia.
- Humans, Immune System, Models, Biological, Models, Theoretical, Prognosis.
Abstract
Severe Acute Respiratory Syndrome (SARS) outbreak in 2002-03 caused morbidity in over 8000 individuals and mortality in 744 in 29 countries. Lymphopenia along with neutrophilia was a feature of SARS, as it is in respiratory syncytial virus (RSV) and Ebola infections, to name a few. Direct infestation of lymphocytes, neutrophils and macrophages by SARS coronavirus (CoV) has been debated as a cause of lymphopenia, but there is no convincing data. Lymphopenia can be caused by glucocorticoids, and thus any debilitating condition has the potential to induce lymphopenia via stress mechanism involving the hypothalamic-pituitary-adrenal axis. Cortisol levels are elevated in patients with RSV and Ebola, and cortisol was higher in SARS patients with lymphopenia before any steroid therapy. Glucocorticoids also down-regulate the production of proinflammatory lymphokines. Because of the insidious presentation, SARS was treated with antibacterial, antiviral and supra-physiological doses of glucocorticoids. Treatment with glucocorticoids complicated the issue regarding lymphopenia, and certainly calls into question the status of lymphokines and their prognostic implications in SARS.
DOI: 10.1016/j.mehy.2008.03.019
PubMed: 18448259
Affiliations:
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lymphopenia in SARS and how reliable is the lymphokine status in glucocorticoid-treated patients?</title><author><name sortKey="Panesar, N S" sort="Panesar, N S" uniqKey="Panesar N" first="N S" last="Panesar">N S Panesar</name><affiliation wicri:level="4"><nlm:affiliation>Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. nspanesar@chuk.edu.hk</nlm:affiliation><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, New Territories</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author></analytic><series><title level="j">Medical hypotheses</title><idno type="ISSN">0306-9877</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cytokines (metabolism)</term><term>Glucocorticoids (therapeutic use)</term><term>Humans</term><term>Hydrocortisone (metabolism)</term><term>Hypothalamus (metabolism)</term><term>Immune System</term><term>Lymphocytes (metabolism)</term><term>Lymphokines (metabolism)</term><term>Lymphopenia (complications)</term><term>Lymphopenia (etiology)</term><term>Lymphopenia (virology)</term><term>Models, Biological</term><term>Models, Theoretical</term><term>Pituitary-Adrenal System (metabolism)</term><term>Prognosis</term><term>Severe Acute Respiratory Syndrome (blood)</term><term>Severe Acute Respiratory Syndrome (complications)</term><term>Severe Acute Respiratory Syndrome (drug therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Axe hypophyso-surrénalien (métabolisme)</term><term>Cytokines (métabolisme)</term><term>Glucocorticoïdes (usage thérapeutique)</term><term>Humains</term><term>Hydrocortisone (métabolisme)</term><term>Hypothalamus (métabolisme)</term><term>Lymphocytes (métabolisme)</term><term>Lymphokines (métabolisme)</term><term>Lymphopénie ()</term><term>Lymphopénie (virologie)</term><term>Lymphopénie (étiologie)</term><term>Modèles biologiques</term><term>Modèles théoriques</term><term>Pronostic</term><term>Syndrome respiratoire aigu sévère ()</term><term>Syndrome respiratoire aigu sévère (sang)</term><term>Syndrome respiratoire aigu sévère (traitement médicamenteux)</term><term>Système immunitaire</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Cytokines</term><term>Hydrocortisone</term><term>Lymphokines</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Glucocorticoids</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lymphopenia</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphopenia</term></keywords><keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Hypothalamus</term><term>Lymphocytes</term><term>Pituitary-Adrenal System</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Axe hypophyso-surrénalien</term><term>Cytokines</term><term>Hydrocortisone</term><term>Hypothalamus</term><term>Lymphocytes</term><term>Lymphokines</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Glucocorticoïdes</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Lymphopénie</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Lymphopenia</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphopénie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Immune System</term><term>Models, Biological</term><term>Models, Theoretical</term><term>Prognosis</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Humains</term><term>Lymphopénie</term><term>Modèles biologiques</term><term>Modèles théoriques</term><term>Pronostic</term><term>Syndrome respiratoire aigu sévère</term><term>Système immunitaire</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Severe Acute Respiratory Syndrome (SARS) outbreak in 2002-03 caused morbidity in over 8000 individuals and mortality in 744 in 29 countries. Lymphopenia along with neutrophilia was a feature of SARS, as it is in respiratory syncytial virus (RSV) and Ebola infections, to name a few. Direct infestation of lymphocytes, neutrophils and macrophages by SARS coronavirus (CoV) has been debated as a cause of lymphopenia, but there is no convincing data. Lymphopenia can be caused by glucocorticoids, and thus any debilitating condition has the potential to induce lymphopenia via stress mechanism involving the hypothalamic-pituitary-adrenal axis. Cortisol levels are elevated in patients with RSV and Ebola, and cortisol was higher in SARS patients with lymphopenia before any steroid therapy. Glucocorticoids also down-regulate the production of proinflammatory lymphokines. Because of the insidious presentation, SARS was treated with antibacterial, antiviral and supra-physiological doses of glucocorticoids. Treatment with glucocorticoids complicated the issue regarding lymphopenia, and certainly calls into question the status of lymphokines and their prognostic implications in SARS.</div></front></TEI><affiliations><list><country><li>Hong Kong</li></country><settlement><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li></orgName></list><tree><country name="Hong Kong"><noRegion><name sortKey="Panesar, N S" sort="Panesar, N S" uniqKey="Panesar N" first="N S" last="Panesar">N S Panesar</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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