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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2020

Open Access 01-12-2020 | Septicemia | Research article

Toll-like receptor 2 downregulation and cytokine dysregulation predict mortality in patients with Staphylococcus aureus bacteremia

Authors: Nak-Hyun Kim, Ji Yeon Sung, Yoon Jung Choi, Su-Jin Choi, Soyeon Ahn, Eunjeong Ji, Moonsuk Kim, Chung Jong Kim, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Eu Suk Kim, Kyoung Un Park, Nam-Joong Kim, Myoung-don Oh, Hong Bin Kim

Published in: BMC Infectious Diseases | Issue 1/2020

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Abstract

Background

Staphylococcus aureus bacteremia (SAB) presents heterogeneously, owing to the differences in underlying host conditions and immune responses. Although Toll-like receptor 2 (TLR2) is important in recognizing S. aureus, its function during S. aureus infection remains controversial. We aimed to examine the association of TLR2 expression and associated cytokine responses with clinical SAB outcomes.

Methods

Patients from a prospective SAB cohort at two tertiary-care medical centers were enrolled. Blood was sampled at several timepoints (≤5 d, 6–9 d, 10–13 d, 14–19 d, and ≥ 20 d) after SAB onset. TLR2 mRNA levels were determined via real-time PCR and serum tumor necrosis factor [TNF]-α, interleukin [IL]-6, and IL-10 levels were analyzed with multiplex-high-sensitivity electrochemiluminescent ELISA.

Results

TLR2 levels varied among 59 SAB patients. On days 2–5, TLR2 levels were significantly higher in SAB survivors than in healthy controls (p = 0.040) and slightly but not significantly higher than non-survivors (p = 0.120), and SAB patients dying within 7 d had lower TLR2 levels than survivors (P = 0.077) although statistically insignificant. IL-6 and IL-10 levels were significantly higher in non-survivors than in survivors on days 2–5 post-bacteremia (P = 0.010 and P = 0.021, respectively), and those dying within 7 d of SAB (n = 3) displayed significantly higher IL-10/TNF-α ratios than the survivors did (P = 0.007).

Conclusion

TLR2 downregulation and IL-6 and IL-10 concentrations suggestive of immune dysregulation during early bacteremia may be associated with mortality from SAB. TLR2 expression levels and associated cytokine reactions during early-phase SAB may be potential prognostic factors in SAB, although larger studies are warranted.
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Metadata
Title
Toll-like receptor 2 downregulation and cytokine dysregulation predict mortality in patients with Staphylococcus aureus bacteremia
Authors
Nak-Hyun Kim
Ji Yeon Sung
Yoon Jung Choi
Su-Jin Choi
Soyeon Ahn
Eunjeong Ji
Moonsuk Kim
Chung Jong Kim
Kyoung-Ho Song
Pyoeng Gyun Choe
Wan Beom Park
Eu Suk Kim
Kyoung Un Park
Nam-Joong Kim
Myoung-don Oh
Hong Bin Kim
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2020
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05641-z

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