1. Systemic infection and microglia activation: a prospective postmortem study in sepsis patients
- Author
-
D.J. van Westerloo, Inge C M Hoogland, Eleonora Aronica, Joo Yeon Engelen-Lee, D. van de Beek, Dunja Westhoff, W.A. van Gool, ANS - Neuroinfection & -inflammation, AII - Infectious diseases, Graduate School, Neurology, APH - Mental Health, APH - Aging & Later Life, and Pathology
- Subjects
lcsh:Immunologic diseases. Allergy ,0301 basic medicine ,Aging ,Pathology ,medicine.medical_specialty ,Sepsis associated encephalopathy ,Immunology ,lcsh:Geriatrics ,Systemic inflammation ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Neuroinflammation ,medicine ,Microglia ,business.industry ,Septic shock ,Research ,Putamen ,Delirium ,Sepsis-Associated Encephalopathy ,medicine.disease ,lcsh:RC952-954.6 ,030104 developmental biology ,medicine.anatomical_structure ,Globus pallidus ,nervous system ,medicine.symptom ,lcsh:RC581-607 ,business ,030215 immunology - Abstract
Background Systemic infection is associated with long-term cognitive deficits and functional decline. In this study we hypothesized that severe systemic inflammation leads to a neuroinflammatory response that is characterized by microglial activation, and that these effects might be more pronounced in patients using medication with anticholinergic side-effects. Methods Based on the results of a pilot study in 8 patients, we assessed the number of MHC-II and CD-68 positive cells by immunohistochemistry and compared the number of microglia in specific brain regions of 16 well-characterized patients with septic shock and 15 controls. Results In the pilot study, patients with sepsis tended to have higher density of MHC-II and CD-68 positive microglia in the basal ganglia (putamen, caudate nucleus and globus pallidus) and of MHC-II positive microglia in the hippocampus. In the validation study, patients with sepsis had a significantly higher number of CD-68 positive cells in hippocampus (1.5 fold; p = 0.012), putamen (2.2 fold; p = 0.008) and cerebellum (2.5 fold; p = 0.011) than control patients. The density of MHC-II positive microglia was similar between sepsis and control groups. There was no consistent correlation between microglia counts and anti-cholinergic activity drugs score. Conclusion In patients who die during septic shock, severe systemic inflammation is accompanied by localized and strong upregulation of CD-68 positive microglia, but not of MHC-II positive microglia. We identified regional differences in the brain with increased microglial activation in putamen, hippocampus and cerebellum.
- Published
- 2019