Patients treated in intensive care units (ICUs) are at high risk of malnutrition and the resulting homeostasis, metabolic, histological and immunological disorders, especially leading to organ failure and increased susceptibility to infection. In 163 patients with malnutrition [mild in 33 (19.6%), moderate in 69 (42.9%), severe in 61 (37.4%)] treated in the ICU, changes in the concentration of selected proteins [interleukin (IL)-1Ra, tumor necrosis factor  (TNF-), soluble tumour necrosis factor receptor-1 (sTNFR1), IL-6, IL-10, sTLR4, MyD88, A20, HSP70, HMGB1] were examined. In the whole group of malnourished patients, median values of sTNFR1, TNF-, IL-6, TLR4, IL-1Ra were significantly increased, while the levels of MyD88 and A20 proteins were significantly reduced (in comparison to the well-nourished healthy group). Only the sTNFR1 protein showed a significant difference between mild, moderate and severe malnutrition, and increased concentrations as the severity of malnutrition increased (the correlation study found that as the degree of malnutrition increased, the sTNFR1 concentrations increased; p = 0.0000, R = 0.5442). It was observed that death was significantly more frequent in the group of patients who on the first day of hospitalization in the ICU scored 5 or more points on the NRS 2002 scale (p = 0.0004). In the patients who died significantly higher concentrations of sTNFR1, IL-6, IL-10, HSP70 were observed in comparison to the patients who survived. The present results are encouraging and indicate the desirability of undertaking multicentre clinical trials including monitoring of sTNFR1 in assessing the severity of malnutrition and immune disorders in the first hours after admission to the ICU, because it can be assumed that without early diagnosis of innate immunity disorders any attempts at their modulation may be ineffective.

中文翻译：

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营养不良程度与危重患者免疫应答选择参数变化之间的关系

在重症监护病房（ICUs）中接受治疗的患者营养不良的风险很高，并导致体内稳态，代谢，组织学和免疫学紊乱，特别是导致器官衰竭和对感染的易感性增加。在ICU中治疗的163名营养不良的患者中[轻度33例（19.6％），中度69例（42.9％），重度61例（37.4％）]，所选蛋白质[白介素（IL）-1Ra，检查了肿瘤坏死因子（TNF-α），可溶性肿瘤坏死因子受体-1（sTNFR1），IL-6，IL-10，sTLR4，MyD88，A20，HSP70，HMGB1]。在整个营养不良患者中，sTNFR1，TNF-α，IL-6，TLR4，IL-1Ra的中位数显着升高，而MyD88和A20蛋白的水平显着降低（与营养良好的健康人群相比）团体）。仅sTNFR1蛋白在轻度，中度和严重营养不良之间显示出显着差异，并且随着营养不良严重程度的增加而浓度升高（相关研究发现，随着营养不良程度的增加，sTNFR1浓度增加； p = 0.0000，R = 0.5442 ）。据观察，在住院的第一天，ICU住院患者在NRS 2002量表中得分达到5分或以上（p = 0.0004）时，死亡的发生率显着增加。与存活的患者相比，在死亡的患者中观察到更高浓度的sTNFR1，IL-6，IL-10，HSP70。