title: The role of dendritic cell alterations in susceptibility to hospital-acquired infections during critical-illness related immunosuppression.
abstract: Systemic inflammatory response syndrome (SIRS) is a common condition in critically ill patients. SIRS is characterized by alteration of both innate and adaptive immunity and causes protracted immunosupression, exposing the patients to severe secondary infections. Dendritic cells (DCs), which play a pivotal role bridging innate and T cell-dependent immunity, exhibit prolonged alterations after SIRS. In an early phase, SIRS causes depletion or systemic activation of immature DCs in parenchymal tissues and lymphoid organs, leading to impaired pathogen detection and presentation. Later on, newly formed DCs acquire a poorly immunogenic phenotype, with poor capacity to capture, process and/or present antigens and to stimulate T cells. Here, we review the studies that describe alterations in DC function post-SIRS. Knowledge about the molecular mechanisms involved are still scarce but their understanding might open new therapeutic avenues to prevent or reduce protracted immunosuppression in critically-ill patients.
authors.affiliation: Department of Microbiology and Immunology, Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.
authors.forename: Antoine
authors.initials: A
authors.lastname: Roquilly
authors.affiliation: Department of Microbiology and Immunology, Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia. Electronic address: j.villadangos@unimelb.edu.au.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Villadangos
mesh_terms: D017951:Antigen Presentation; D000942:Antigens, Bacterial / Q000235:genetics / Q000276:immunology; D000956:Antigens, Viral / Q000235:genetics / Q000276:immunology; D001424:Bacterial Infections / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D016638:Critical Illness; D003428:Cross Infection / Q000276:immunology* / Q000382:microbiology / Q000473:pathology / Q000821:virology; D003713:Dendritic Cells / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D004198:Disease Susceptibility; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology* / Q000382:microbiology / Q000473:pathology / Q000821:virology; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D014777:Virus Diseases / Q000276:immunology / Q000473:pathology / Q000821:virology
chemical_list: D000942:Antigens, Bacterial; D000956:Antigens, Viral
keywords: Antigen-presentation; Critical-diseases; Dendritic cells; Infection; Systemic inflammation