Journal of Molecular Biomarkers and Clinical Trials

The Level of Regulatory T Lymphocytes may be Correlated with Outcomes in Early Sepsis

Published on: 2015-08-19

Abstract

Severe sepsis is associated with high mortality; however, the mortality of the secondary infection after severe sepsis is often higher than that of primary infection. A weaker pro-inflammatory response was found in survivors in primary inflection. The levels of pro-inflammatory cytokines in mid-term survivors, late death due to the secondary infection, were significantly higher than those in long-term survivors. Our hypothesis is that regulatory T cells (Tregs) suppress adaptive immune response in non-survivors and mid-term survivors. Therefore, the levels of Tregs between non-survivors and survivors, as well as between mid-term and long-term survivors in severe sepsis patients were examined to verify the hypothesis. Total 24 cases of severe sepsis, with outcomes of the early death (n = 5), mid-term survivors (n = 6), and long-term survivors (n = 13) were enrolled. The levels of lymphocytes, Tregs, monocytes, granulocytes, and neutrophil CD64 molecules were analyzed on days 0 (within 12 hours after the onset of the first organ failure due to sepsis), 1, 2, and 3 by flow cytometry and the levels of each variable were compared between groups by the mixed model. The recovery of lymphocytes was only observed The level of Tregs was significantly different between the early death and survivors, the early death and long-term survivors, in long-term survivors, as well as mid-term and long-term survival groups. The levels of neutrophil CD64 molecules indicated the ongoing infection. Results indicate that Tregs might affect immune homeostasis in patients with severe sepsis, influencing outcomes of early death, mid-term survival, and long-term survival.

Keywords

Severe Sepsis, Regulatory T Lymphocytes, Lymphocytes, Lymphocytopenia, Monocytes