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Doctoral Thesis
DOI
https://doi.org/10.11606/T.42.2018.tde-05102018-104156
Document
Author
Full name
Monique Thaís Costa Fonseca
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Steiner, Alexandre Alarcon (President)
Barbuto, Jose Alexandre Marzagao
Costa, Soraia Kátia Pereira
Glezer, Isaias
Wanner, Samuel Penna
Title in Portuguese
Hipotermia na sepse: desenvolvimento natural e valor biológico.
Keywords in Portuguese
Febre
Hipotermia
Humanos
Macrófagos
Neutrófilos
Ratos
Sepse
Temperatura
Abstract in Portuguese
A sepse é sempre acompanhada de mudanças na temperatura corporal, seja esta febre ou hipotermia. O presente trabalho tem como objetivos principais (1) caracterizar o curso temporal de hipotermia em um grupo raro de pacientes sépticos; (2) desenvolver um modelo experimental bem controlado de sepse grave monobacteriana e; (3) estudar mecanicamente como o pulmão é preservado na sepse frente à virada de febre para hipotermia. Nossos resultados mostraram, pela primeira vez, que a hipotermia em pacientes sépticos é um fenômeno transitório, não terminal. Ainda desenvolvemos um modelo experimental de sepse grave, no qual observamos que a hipotermia provoca a reprogramação das principais células envolvidas na resposta inflamatória. Essas mudanças favorecem o hospedeiro, pois induzem diminuição do infiltrado inflamatório e manteve a infecção controlada. Logo, podemos concluir que a hipotermia é um fenômeno transitório, auto-limitante e não terminal, diferente da resposta desregulada e progressiva que se acreditava existir.
Title in English
Hypothermia in sepsis: natural development and biological value.
Keywords in English
Fever
Humans
Hypothermia
Macrophages
Neutrophils
Rats
Sepsis
Temperature
Abstract in English
Sepsis is always accompanied by changes in body temperature, whether it is fever or hypothermia. The present study has as main objectives (1) to characterize the temporal course of hypothermia in a rare group of septic patients; (2) to develop a well-controlled experimental model of severe monobacterial sepsis and; (3) to mechanically study how the lung is preserved in the sepsis in the face of the onset of fever for hypothermia. Our results showed, for the first time, that hypothermia in septic patients is a transitory, non-terminal phenomenon. We have also developed an experimental model of severe sepsis, in which we observed that hypothermia causes reprogramming of the main cells involved in the inflammatory response. These changes favor the host, as they induce a decrease in the inflammatory infiltrate and kept the infection under control. Therefore, we can conclude that hypothermia is a transitory phenomenon, self-limiting and not terminal, different from the deregulated and progressive response that was believed to exist.
 
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Publishing Date
2018-10-05
 
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