Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infectionReport as inadecuate




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Critical Care

, 14:R96

First Online: 26 May 2010Received: 07 December 2009Revised: 19 February 2010Accepted: 26 May 2010

Abstract

IntroductionAlthough major changes of the immune system have been described in sepsis, it has never been studied whether these may differ in relation to the type of underlying infection or not. This was studied for the first time.

MethodsThe statuses of the innate and adaptive immune systems were prospectively compared in 505 patients. Whole blood was sampled within less than 24 hours of advent of sepsis; white blood cells were stained with monoclonal antibodies and analyzed though a flow cytometer.

ResultsExpression of HLA-DR was significantly decreased among patients with severe sepsis-shock due to acute pyelonephritis and intraabdominal infections compared with sepsis. The rate of apoptosis of natural killer NK cells differed significantly among patients with severe sepsis-shock due to ventilator-associated pneumonia VAP and hospital-acquired pneumonia HAP compared with sepsis. The rate of apoptosis of NKT cells differed significantly among patients with severe sepsis-shock due to acute pyelonephritis, primary bacteremia and VAP-HAP compared with sepsis. Regarding adaptive immunity, absolute counts of CD4-lymphocytes were significantly decreased among patients with severe sepsis-shock due to community-acquired pneumonia CAP and intraabdominal infections compared with sepsis. Absolute counts of B-lymphocytes were significantly decreased among patients with severe sepsis-shock due to CAP compared with sepsis.

ConclusionsMajor differences of the early statuses of the innate and adaptive immune systems exist between sepsis and severe sepsis-shock in relation to the underlying type of infection. These results may have a major impact on therapeutics.

AbbreviationsANOVAanalysis of variance

APACHEacute physiology and chronic health evaluation

CAPcommunity-acquired pneumonia

EDTAethyldiamine tetracetic acid

HAPhospital-acquired pneumonia

NKnatural killer

PAMPspathogen-associated molecular patterns

PBSphosphate buffered saline

PRRspattern recognition receptors

SEstandard error

TLRtoll-like receptor

VAPventilator-associated pneumonia.

Electronic supplementary materialThe online version of this article doi:10.1186-cc9031 contains supplementary material, which is available to authorized users.

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Author: Charalambos Gogos - Antigone Kotsaki - Aimilia Pelekanou - George Giannikopoulos - Ilia Vaki - Panagiota Maravitsa - Stephan

Source: https://link.springer.com/







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