Nosocomial infections and immunity: lesson from brain-injured patients.
Of brain-injured patients admitted to intensive care units, a significant number acquires nosocomial infections. Increased susceptibility to infectious agents could, at least partly, be due to transient immunodepression triggered by brain damage. Immune deficiency in patients with severe brain injury primarily involves T cell dysfunction. However, humoral and phagocytic deficiencies are also detectable. Activation of the hypothalamo-pituitary-adrenal axis and the sympathetic nervous system plays a crucial role in brain-mediated immunodepression. In this review we discuss the role of immunodepression in the development of nosocomial infections and clinical trials on immunomodulation in brain-injured patients with hospital-acquired infections.
Department of Neurology, Jagiellonian University, Krakow, Poland. dziedzictom@mediclub.pl
Tomasz
T
Dziedzic
Agnieszka
A
Slowik
Andrzej
A
Szczudlik
D001930:Brain Injuries / Q000276:immunology*; D003428:Cross Infection / Q000209:etiology*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology; D016867:Immunocompromised Host; D007153:Immunologic Deficiency Syndromes; D007167:Immunotherapy; D007362:Intensive Care Units; D010913:Pituitary-Adrenal System / Q000276:immunology