title: [The immunomodulatory effects of hypertonic saline on sepsis patients].
abstract: OBJECTIVE
  To approach the immunomodulatory effects of hypertonic saline (HTS) on sepsis patients.
  
  
  METHODS
  Twenty-four septic patients admitted to surgical intensive care unit (SICU) received 5% HTS for fluid  resuscitation were prospectively enrolled from January 2009 to September 2010. Blood samples were collected at 15 minutes before, and at 15 minutes and 6, 12, and 24 hours after HTS infusion, the ability of respiratory burst of polymorphonuclear neutrophils (PMN) and the surface expression of CD11b and L-selectin in fresh whole blood was evaluated with flow cytometer. The plasma was collected to determine the solubility intercellular adhesion molecule-1 (sICAM-1), solubility L-selectin (sL-selectin), tumor necrosis factor-α(TNF-α) and interleukins (IL-6, IL-1β).
  
  
  RESULTS
  The baseline before HTS infusion was set as 100. Six hours after HTS infusion, the ability of respiratory burst of PMN was significantly increased [(160.0±19.6)%] compared with the baseline (P<0.05), and then gradually recovered  to  normal  level. The  expression  of  CD11b  and  L-selectin  in  the  surface of PMN was reduced rapidly at 15 minutes after HTS infusion, and to nadir at 12 hours [(70.4±5.7)%, (70.6±8.1)%], and L-selectin recovered to the normal level at 24 hours. Within short-term of HTS infusion, plasma inflammatory factor TNF-α was significantly decreased, and sustained a low level until 12 hours, and then gradually increased. There was no change in IL-1β. IL-6 and sICAM-1 was gradually increased, and peaked at 24 hours and 12 hours respectively, and remained at a high level. sL-selectin  increased  shortly  at  15 minutes  after  HTS  infusion  compared  with  baseline, and  remained  the level to 12 hours, and recovered to baseline at 24 hours.
  
  
  CONCLUSIONS
  Delayed administration of HTS may have an immunomodulatory effect on sepsis patients, which could inhibit the activation of PMN.
authors.affiliation: Nanjing General Hospital of Nanjing Command, PLA, Nanjing University School of Medicine, Jiangsu, China.
authors.forename: Wei-wei
authors.initials: WW
authors.lastname: Ding
authors.forename: Wei-qin
authors.initials: WQ
authors.lastname: Li
authors.forename: Zhi-hui
authors.initials: ZH
authors.lastname: Tong
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jie-shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D039481:CD11b Antigen / Q000097:blood; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D019041:L-Selectin / Q000097:blood; D008297:Male; D012151:Resuscitation; D012189:Retrospective Studies; D012462:Saline Solution, Hypertonic / Q000494:pharmacology / Q000627:therapeutic use*; D018805:Sepsis / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D039481:CD11b Antigen; C573420:ICAM1 protein, human; C508585:IL1B protein, human; C508600:IL6 protein, human; C509295:ITGAM protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D012462:Saline Solution, Hypertonic; D014409:Tumor Necrosis Factor-alpha; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin