RESUMO
BACKGROUND: Septic shock is a life-threatening condition that challenges immune cells to reprogram their mitochondrial metabolism towards to increase ATP synthesis for building an appropriate immunity. This could print metabolic signatures in mitochondria whose association with disease progression and clinical outcomes remain elusive. METHOD: This is a single-center prospective cohort study performed in the ICU of one tertiary referral hospital in Brazil. Between November 2017 and July 2018, 90 consecutive patients, aged 18 years or older, admitted to the ICU with septic shock were enrolled. Seventy-five patients had Simplified Acute Physiology Score (SAPS 3) assessed at admission, and Sequential Organ Failure Assessment (SOFA) assessed on the first (D1) and third (D3) days after admission. Mitochondrial respiration linked to complexes I, II, V, and biochemical coupling efficiency (BCE) were assessed at D1 and D3 and Δ (D3-D1) in isolated lymphocytes. Clinical and mitochondrial endpoints were used to dichotomize the survival and death outcomes. Our primary outcome was 6-month mortality, and secondary outcomes were ICU and hospital ward mortality. RESULTS: The mean SAPS 3 and SOFA scores at septic shock diagnosis were 75.8 (± 12.9) and 8 (± 3) points, respectively. The cumulative ICU, hospital ward, and 6-month mortality were 32 (45%), 43 (57%), and 50 (66%), respectively. At the ICU, non-surviving patients presented elevated arterial lactate (2.8 mmol/L, IQR, 2-4), C-reactive protein (220 mg/L, IQR, 119-284), and capillary refill time (5.5 s, IQR, 3-8). Respiratory rates linked to CII at D1 and D3, and ΔCII were decreased in non-surviving patients. Also, the BCE at D1 and D3 and the ΔBCE discriminated patients who would evolve to death in the ICU, hospital ward, and 6 months after admission. After adjusting for possible confounders, the ΔBCE value but not SOFA scores was independently associated with 6-month mortality (RR 0.38, CI 95% 0.18-0.78; P = 0.009). At a cut-off of - 0.002, ΔBCE displayed 100% sensitivity and 73% specificity for predicting 6-month mortality CONCLUSIONS: The ΔBCE signature in lymphocytes provided an earlier recognition of septic shock patients in the ICU at risk of long-term deterioration of health status.
RESUMO
Introdução: A erva-mate tem sido implicada como possível fator de risco para o desenvolvimento do câncer de língua. Objetivo: O objetivo do estudo é o de avaliar as alterações patológicas bem como a expressão imuno-histoquímica nas amostras de língua de ratos bebedores de erva-mate. Material e método: No estudo foram analisados 75 ratos Wistar adultos com 5 meses de vida (peso acima de 300 gramas cada um) que fizeram a ingestão de erva-mate diariamente por 9 semanas. Após, foram eutanasiados e a língua retirada para avaliação anatomopatológica e imuno-histoquímica. Resultados: Não foram observadas alterações ao exame anatomopatológico e imuno-histoquímico compatível com processo neoplásico nas 75 peças analisadas. Conclusão: Não foram observadas associações nas amostras de língua de ratos bebedores de erva-mate nos exames anatomopatológico e imuno-histoquímico
Introduction: mate has been implicated as a possible risk factor for the development of cancer of the tongue.Aim: The aim of the study is to evaluate the pathological alterations as well as the immunohistochemical expression in samples from the tongues of mate drinking rats. Material and Method: In the study, 75 adult Wistar, aged 5 months (weighing over 300 grams each) that had ingested mate on a daily basis for 9 weeks were analyzed.Following sacrifice, the tongue was removed for anatomical-pathological and immunohistochemical evaluation.Results: In the anatomical-pathological and immunohistochemical examination, no alterations compatible with neoplasic processes were observed in the 75 pieces analyzed. Conclusion: No associations were found in the samples of tongue from matedrinking rats in the anatomical-pathological and immunohistochemical examinations
