1. Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection
- Author
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Ioanna Dimopoulou, Evangelos J. Giamarellos-Bourboulis, Fotini Baziaka, Diamantis Plachouras, Kyriaki Kanellakopoulou, Panagiota Maravitsa, Ioannis Katsarolis, Heleni Mylona, Anastasia Antonopoulou, A. Ioakeimidou, Margarita Mpalla, Zoi Alexiou, Ilias Papanikolaou, Maria Souli, Aikaterini Charalambous, M Lignos, Phylis Klouva-Molyvdas, Monika Sartzi, Helen Giamarellou, Pantelis Koutoukas, Ioannis Floros, Ioannis Perdios, Georgia Kontopithari, Charalambos Gogos, Aikaterini Spyridaki, Sofia Athanassia, Vissaria Sakka, Irini Mavrou, George C. Zografos, Vassilios Skouras, Sofia Christodoulou, Korina Lymberopoulou, Martha Michalia, Petros Kopterides, Charalambos Massouras, Niki Karabela, Ioannis Strouvalis, Efstratios Mainas, Nina Maggina, George Andrianopoulos, Efthymia Giannitsioti, Kalliopi Rigaki, Aimilia Pelekanou, Hariklia Kranidioti, Konstantinos Protopapas, Maria Patrani, Konstantinos Louis, Vassiliki Karagianni, Androniki Marioli, Apostolos Armaganidis, Vassilios Mytas, Panagiotis Gkanas, George Giannikopoulos, Aikaterini Pistiki, Ioannis Koutelidakis, Stephanos Adamis, Thomas Tsaganos, Ilia Vaki, Antigone Kotsaki, Konstantinos Mandragos, and Konstantinos Papanikolaou
- Subjects
Male ,Letter ,Apoptosis ,Bacteremia ,Adaptive Immunity ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Sepsis ,Immune system ,medicine ,Humans ,Prospective Studies ,Whole blood ,Aged ,Aged, 80 and over ,B-Lymphocytes ,Greece ,business.industry ,Research ,Immunity ,HLA-DR Antigens ,Middle Aged ,medicine.disease ,Natural killer T cell ,Acquired immune system ,Immunity, Innate ,CD4 Lymphocyte Count ,Killer Cells, Natural ,Pneumonia ,Shock (circulatory) ,Immunology ,Female ,medicine.symptom ,business - Abstract
Introduction Although 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. Methods The 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. Results Expression 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. Conclusions Major 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.
- Published
- 2010