Syndrome of persistent inflammation, the immune suppression and catabolism in surgery


Syndrome of persistent inflammation, the immune suppression and catabolism in surgery

Author Biographies

S. M. Chuklin, Lviv Regional Clinical Hospital

Chooklin S.- MD, DSci(Med), professor,
Department of Surgery,
Lviv Regional Clinical Hospital,
Nekrasova 4, Lviv 79010, Ukraine.

S. S. Chuklin, Lviv Regional Clinical Hospital

Chuklin S.- MD, resident,
Department of Surgery,
Lviv Regional Clinical Hospital,
Nekrasova 4, Lviv 79010, Ukraine.

G. V. Shershen, Lviv Regional Clinical Hospital

Shershen G.- MD, doctor,
Department of Anesthesiology an Intensive Care,
Lviv Regional Clinical Hospital,
Nekrasova 4, Lviv 79010, Ukraine.


Moore FA, Moore EE. Evolving concepts in the pathogenesis of postinjury multiple organ failure. Surg Clin North Am. 1995;75(2):257-77. doi: 0.1016/s0039-6109(16)46587-4.

Caraballo C, Jaimes F. Organ Dysfunction in Sepsis: An Ominous Trajectory From Infection To Death. Yale J Biol Med. 2019;92(4):629-40. PMID: 31866778.

Cole E, Gillespie S, Vulliamy P, Brohi K. Multiple organ dysfunction after trauma. Br J Surg. 2020;107(4):402-12. doi: 10.1002/bjs.11361.

Waydhas C, Nast-Kolb D, Jochum M, Trupka A, Lenk S, Fritz H, et al. Inflammatory mediators, infection, sepsis, and multiple organ failure after severe trauma. Arch Surg. 1992;127(4):460-7. doi: 10.1001/archsurg.1992.01420040106019.

Balk RA, Bone RC. The septic syndrome. Definition and clinical implications. Crit Care Clin. 1989;5(1):1-8. PMID: 2647221.

Sauaia A, Moore EE, Johnson JL, Chin TL, Banerjee A, Sperry JL, et al. Temporal trends of postinjury multiple-organ failure: Still resource intensive, morbid, and lethal. J Trauma Acute Care Surg. 2014;76(3):582-92. doi: 10.1097/TA.0000000000000147.

Moore FA, Sauaia A, Moore EE, Haenel JB, Burch JM, Lezotte DC. Postinjury multiple organ failure: a bimodal phenomenon. J Trauma. 1996;40(4):501-10. doi: 10.1097/00005373-199604000-00001.

Bone RC. Immunologic dissonance: A continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS). Ann Intern Med. 1996;125(8):680-7. doi: 10.7326/0003-4819-125-8-199610150-00009.

Bone RC. Toward a theory regarding the pathogenesis of the systemic inflammatory response syndrome: what we do and do not know about cytokine regulation. Crit Care Med. 1996;24(1):163-72. doi: 10.1097/00003246-199601000-00026.

Gentile LF, Cuenca AG, Efron PA, Ang D, Bihorac A, McKinley BA, et al. Persistent inflammation and immunosuppression: A common syndrome and new horizon for surgical intensive care. J Trauma Acute Care Surg. 2012;72(6):1491-501. doi: 10.1097/TA.0b013e318256e000.

Moore FA, Moore EE. The evolving rationale for early enteral nutrition based on paradigms of multiple organ failure: a personal journey. Nutr Clin Pract. 2009;24(3):297-304. doi: 10.1177/0884533609336604.

Xiao W, Mindrinos MN, Seok J, Cuschieri J, Cuenca AG, Gao H, et al. A genomic storm in critically injured humans. J Exp Med. 2011;208(13):2581-90. doi: 10.1084/jem.20111354.

Cuschieri J, Johnson JL, Sperry J, West MA, Moore EE, Minei JP, et al. Benchmarking outcomes in the critically injured trauma patient and the effect of implementing standard operating procedures. Ann Surg. 2012; 255(5):993-9. doi: 10.1097/SLA.0b013e31824f1ebc.

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580-637. doi: 10.1097/CCM.0b013e31827e83af.

Rhodes A, Phillips G, Beale R, Cecconi M, Chiche JD, De Backer D, et al. The Surviving Sepsis Campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study). Intensive Care Med. 2015;41(9):1620-8. doi: 10.1007/s00134-015-3906-y.

Mira JC, Gentile LF, Mathias BJ, Efron PA, Brakenridge SC, Mohr AM, et al. Sepsis pathophysiology, chronic critical illness, and persistent inflammation-immunosuppression and catabolism syndrome. Crit Care Med. 2017;45(2):253-62. doi:10.1097/CCM.0000000000002074.

Stortz JA, Murphy TJ, Raymond SL, Mira JC, Ungaro R, Dirain ML, et al. Evidence for persistent immune suppression in patients who develop chronic critical illness after sepsis. Shock. 2018;49(3):249-58. doi: 10.1097/SHK.0000000000000981.

Stortz JA, Mira JC, Raymond SL, Loftus TJ, Ozrazgat Baslanti T, Wang Z, et al. Benchmarking clinical outcomes and the immunocatabolic phenotype of chronic critical illness after sepsis in surgical intensive care unit patients. J Trauma Acute Care Surg. 2018;84(2):342-9. doi: 10.1097/TA.0000000000001758.

Kahn JM, Le T, Angus DC, Cox CE, Hough CL, White DB, et al. ProVent Study Group I. The epidemiology of chronic critical illness in the United States. Crit Care Med. 2015;43(2):282-7. doi: 10.1097/CCM.0000000000000710.

Bryant SE, McNabb K. Postintensive Care Syndrome. Crit Care Nurs Clin North Am. 2019;31(4):507-16. doi: 10.1016/j.cnc.2019.07.006.

Rose L, Istanboulian L, Allum L, Burry L, Dale C, Hart N, et al. Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review. Crit Care Explor. 2019;1(4):e0005. doi: 10.1097/CCE.0000000000000005.

Marchioni A, Fantini R, Antenora F, Clini E, Fabbri L. Chronic critical illness: the price of survival. Eur J Clin Invest. 2015;45(12):1341-9. doi: 10.1111/eci.12547.

Iwashyna TJ, Hodgson CL, Pilcher D, Bailey M, van Lint A, Chavan S, et al. Timing of onset and burden of persistent critical illness in Australia and New Zealand: a retrospective, population-based, observational study. Lancet Respir Med. 2016;4(7):566-73. doi: 10.1016/S2213-2600(16)30098-4.

Callcut RA, Wakam G, Conroy AS, Kornblith LZ, Howard BM, Campion EM, et al. Discovering the truth about life after discharge: Long-¬term trauma-related mortality. J Trauma Acute Care Surg. 2016;80(2):210-17. doi: 10.1097/TA.0000000000000930.

Loftus TJ, Mira JC, Ozrazgat-Baslanti T, Ghita GL, Wang Z, Stortz JA, et al. Sepsis and critical illness research center investigators: Protocols and standard operating procedures for a prospective cohort study of sepsis in critically ill surgical patients. BMJ Open. 2017;7(7):e015136. doi: 10.1136/bmjopen-2016-015136.

Bienvenu OJ. What Do We Know About Preventing or Mitigating Postintensive Care Syndrome? Crit Care Med. 2019;47(11):1671-2. doi: 10.1097/CCM.0000000000003990.

Rawal G, Yadav S, Kumar R. Post-intensive Care Syndrome: an Overview. J Transl Int Med. 2017;5(2):90-2. doi: 10.1515/jtim-2016-0016.

Guirgis FW, Brakenridge S, Sutchu S, Khadpe JD, Robinson T, Westenbarger R, et al. The long-term burden of severe sepsis and septic shock: Sepsis recidivism and organ dysfunction. J Trauma Acute Care Surg. 2016;81(3):525-32. doi: 10.1097/TA.0000000000001135.

Mira JC, Cuschieri J, Ozrazgat-Baslanti T, Wang Z, Ghita GL, Loftus TJ, et al. The epidemiology of chronic critical illness after severe traumatic injury at two-level one trauma centers. Crit Care Med. 2017;45(12):1989-96. doi: 10.1097/CCM.0000000000002697.

Davidson GH, Hamlat CA, Rivara FP, Koepsell TD, Jurkovich GJ, Arbabi S. Long-term survival of adult trauma patients. JAMA. 2011;305(10):1001-7. doi: 10.1001/jama.2011.259.

Yende S, Austin S, Rhodes A, Finfer S, Opal S, Thompson T, et al. Long-term quality of life among survivors of severe sepsis: Analyses of two international trials. Crit Care Med. 2016;44(8):1461-7. doi: 10.1097/CCM.0000000000001658.

Masch JL, Bhutiani N, Bozeman MC. Feeding During Resuscitation After Burn Injury. Nutr Clin Pract. 2019;34(5):666-71. doi: 10.1002/ncp.10400.

Mason SA, Nathens AB, Byrne JP, Ellis J, Fowler RA, Gonzalez A, et al. Association between burn injury and mental illness among burn survivors: A population-based, self-matched, longitudinal cohort study. J Am Coll Surg. 2017;225(4):516-24. doi: 10.1016/j.jamcollsurg.2017.06.004.

Yang N, Li B, Ye B, Ke L, Chen F, Lu G, et al. The long-term quality of life in patients with persistent inflammation-immunosuppression and catabolism syndrome after severe acute pancreatitis: A retrospective cohort study. J Crit Care. 2017;42:101-6. doi: 10.1016/j.jcrc.2017.07.013.

Horiguchi H, Loftus TJ, Hawkins RB, Raymond SL, Stortz JA, Hollen MK, et al. Innate immunity in the persistent inflammation, immunosuppression, and catabolism syndrome and its implications for therapy. Front Immunol. 2018;9:595. doi: 10.3389/fimmu.2018.00595.

Loftus TJ, Mira JC, Stortz JA, Ozrazgat-Baslanti T, Ghita GL, Wang Z, et al. Persistent inflammation and anemia among critically ill septic patients. J Trauma Acute Care Surg. 2019;86(2):260-7. doi: 10.1097/TA.0000000000002147.

Rosenthal M, Gabrielli A, Moore F. The evolution of nutritional support in long term ICU patients: from multisystem organ failure to persistent inflammation immunosuppression catabolism syndrome. Minerva Anestesiol. 2016;82(1):84-96. PMID: 25697882.

Hawkins RB, Raymond SL, Stortz JA, Horiguchi H, Brakenridge SC, Gardner A, et al. Chronic Critical Illness and the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome. Front Immunol. 2018;9:1511. doi: 10.3389/fimmu.2018.01511.

You JW, Lee SJ, Kim YE, Cho YJ, Jeong YY, Kim HC, et al. Association between weight change and clinical outcomes in critically ill patients. J Crit Care. 2013;28(6):923-27. doi: 10.1016/j.jcrc.2013.07.055.

Bharadwaj S, Ginoya S, Tandon P, Gohel TD, Guirguis J, Vallabh H, et al. Malnutrition: Laboratory markers vs nutritional assessment. Gastroenterol. Rep. 2016;4(4):272-80. doi: 10.1093/gastro/gow013.

Santonocito C, De Loecker I, Donadello K, Moussa MD, Markowicz S, Gullo A, et al. C-reactive protein kinetics after major surgery. Anesth. Analg. 2014;119(3):624-29. doi: 10.1213/ANE.0000000000000263.

Nakamura K, Ogura K, Nakano H, Naraba H, Takahashi Y, Sonoo T, et al. C-reactive protein clustering to clarify persistent inflammation, immunosuppression and catabolism syndrome. Intensive Care Med. 2020;46(3):437-43. doi: 10.1007/s00134-019-05851-3.

McFadyen JD, Zeller J, Potempa LA, Pietersz GA, Eisenhardt SU, Peter K. C-Reactive Protein and Its Structural Isoforms: An Evolutionary Conserved Marker and Central Player in Inflammatory Diseases and Beyond. Subcell Biochem. 2020;94:499-520. doi: 10.1007/978-3-030-41769-7_20.

Ngwa DN, Agrawal A. Structure-Function Relationships of C-Reactive Protein in Bacterial Infection. Front Immunol. 201926;10:166. doi: 10.3389/fimmu.2019.00166.

Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754. doi: 10.3389/fimmu.2018.00754.

Moshage HJ, Janssen JA, Franssen JH, Hafkenscheid JC, Yap SH. Study of the molecular mechanism of decreased liver synthesis of albumin in inflammation. J Clin Invest. 1987;79(6):1635-41. doi: 10.1172/JCI113000

Prado BL, Qian Y. Anti-cytokines in the treatment of cancer cachexia. Ann Palliat Med. 2019;8(1):67-79. doi: 10.21037/apm.2018.07.06.

Hesselink L, Hoepelman RJ, Spijkerman R, de Groot MCH, van Wessem KJP, Koenderman L, et al. Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) after Polytrauma: A Rare Syndrome with Major Consequences. J Clin Med. 2020;9(1):191. doi: 10.3390/jcm9010191.

Rosenthal MD, Moore FA. Persistent inflammation, immunosuppression, and catabolism: Evolution of multiple organ dysfunction. Surg Infect (Larchmt). 2016;17(2):167-72. doi: 10.1089/sur.2015.184.

Dos Santos C, Hussain SN, Mathur S, Picard M, Herridge M, Correa J, et al. Mechanisms of chronic muscle wasting and dysfunction after an intensive care unit stay. A pilot study. Am J Respir Crit Care Med. 2016;194(7):821-30. doi:10.1164/rccm.201512-2344OC.

Jeschke MG, Chinkes DL, Finnerty CC, Kulp G, Suman OE, Norbury WB, et al. Pathophysiologic response to severe burn injury. Ann Surg. 2008;248(3):387-401. doi:10.1097/SLA.0b013e3181856241.

Puthucheary ZA, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310(15):1591-600. doi:10.1001/jama.2013.278481.

Picca A, Lezza AMS, Leeuwenburgh C, Pesce V, Calvani R, Bossola M, et al. Circulating mitochondrial DNA at the crossroads of mitochondrial dysfunction and inflammation during aging and muscle wasting disorders. Rejuvenation Res. 2018;21(4):350-9. doi: 10.1089/rej.2017.1989.

Manz MG, Boettcher S. Emergency granulopoiesis. Nat Rev Immunol. 2014;14(5):302-14. doi: 10.1038/nri3660.

Talmadge JE, Gabrilovich DI. History of myeloid-derived suppressor cells. Nat Rev Cancer. 2013;13(10):739-52. doi: 10.1038/nrc3581.

Delano MJ, Scumpia PO, Weinstein JS, Coco D, Nagaraj S, Kelly-Scumpia KM, et al. MyD88-dependent expansion of an immature GR-1(+)CD11b(+) population induces T cell suppression and Th2 polarization in sepsis. J Exp Med. 2007;204(6):1463-74. doi: 10.1084/jem.20062602.

Sander LE, Sackett SD, Dierssen U, Beraza N, Linke RP, Müller M, et al. Hepatic acute-phase proteins control innate immune responses during infection by promoting myeloid-derived suppressor cell function. J Exp Med. 2010 Jul 5;207(7):1453-64. doi: 10.1084/jem.20091474.

Mathias B, Delmas AL, Ozrazgat-Baslanti T, Vanzant EL, Szpila BE, Mohr AM, et al. Human myeloid-derived suppressor cells are associated with chronic immune suppression after severe sepsis/septic shock. Ann Surg. 2017; 265(4):827-34. doi:10.1097/SLA.0000000000001783.

Uhel F, Azzaoui I, Gregoire M, Pangault C, Dulong J, Tadie JM, et al. Early expansion of circulating granulocytic myeloid-derived suppressor cells predicts development of nosocomial infections in patients with sepsis. Am J Respir Crit Care Med. 2017;196(3):315-27. doi: 10.1164/rccm.201606-1143OC.

Hotchkiss RS, Moldawer LL. Parallels between cancer and infectious disease. N Engl J Med. 2014;371(4):380-3. doi: 10.1056/NEJMcibr1404664.

Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL. Sepsis and septic shock. Nat Rev Dis Primers. 2016;2:16045. doi: 10.1038/nrdp.2016.45.

Nacionales DC, Szpila B, Ungaro R, Lopez MC, Zhang J, Gentile LF, et al. A detailed characterization of the dysfunctional immunity and abnormal myelopoiesis induced by severe shock and trauma in the aged. J Immunol. 2015;195(5):2396-407. doi: 10.4049/jimmunol.1500984.

Zhang H, Rodriguez S, Wang L, Wang S, Serezani H, Kapur R, et al. Sepsis induces hematopoietic stem cell exhaustion and myelosuppression through distinct contributions of TRIF and MYD88. Stem Cell Reports. 2016;6(6):940-56. doi: 10.1016/j.stemcr.2016.05.002.

Prescott HC, Angus DC. Enhancing recovery from sepsis: A review. JAMA. 2018;319(1):62-75. doi: 10.1001/jama.2017.17687.

van der Poll T, van de Veerdonk FL, Scicluna BP, Netea MG. The immunopathology of sepsis and potential therapeutic targets. Nat Rev Immunol. 2017;17(7):407-20. doi: 10.1038/nri.2017.36.

Larkin J, Chiarion-Sileni V, Gonzalez R, Grob JJ, Cowey CL, Lao CD, et al. Combined nivolumab and ipilimumab or monotherapy in untreated melanoma. N Engl J Med. 2015;373(1):23-34. doi: 10.1056/NEJMoa1504030.

Motzer RJ, Escudier B, McDermott DF, George S, Hammers HJ, Srinivas S, et al. Nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med. 2015;373(19):1803-13. doi: 10.1056/NEJMoa1510665.

Brahmer J, Reckamp KL, Baas P, Crino L, Eberhardt WE, Poddubskaya E, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med. 2015;373(2):123-35. doi: 10.1056/NEJMoa1504627.

Rosenthal MD, Kamel AY, Rosenthal CM, Brakenridge S, Croft CA, Moore FA. Chronic critical illness: Application of what we know. Nutr Clin Pract. 2018;33(1):39-45. doi: 10.1002/ncp.10024.

Chao T, Porter C, Herndon DN, Siopi A, Ideker H, Mlcak RP, et al. Propranolol and oxandrolone therapy accelerated muscle recovery in burned children. Med Sci Sports Exerc. 2018;50(3):427-35. doi: 10.1249/MSS.0000000000001459.

How to Cite
Chuklin, S. M., Chuklin, S. S., & Shershen, G. V. (2020). Syndrome of persistent inflammation, the immune suppression and catabolism in surgery. Klinicheskaia Khirurgiia, 87(3-4), 78-85.