Marked elevation of human circulating CD4+CD25+ regulatory T cells in sepsis-induced immunoparalysis
作者:
Guillaume,
Monneret Anne-Lise,
Debard Fabienne,
Venet Julien,
Bohe Olivier,
Hequet Jacques,
Bienvenu Alain,
期刊:
Critical Care Medicine
(OVID Available online 2003)
卷期:
Volume 31,
issue 7
页码: 2068-2071
ISSN:0090-3493
年代: 2003
出版商: OVID
关键词: human leukocyte antigen-DR;immunoparalysis;T lymphocytes;CD4+CD25+ T cells;septic shock
数据来源: OVID
摘要:
ObjectiveImmunoparalysis has recently emerged as a possible cause explaining the failure of clinical trials in septic shock. Because human peripheral blood CD4+CD25+ T cells have been characterized as suppressor T cells, we hypothesized they might be increased in sepsis-induced immunoparalysis.DesignProspective, observational, clinical study.SettingAdult intensive care units in a university hospital.SubjectsPatients with septic shock (n = 16) and healthy individuals (n = 36).InterventionsNone.Measurements and Main ResultsIn patients with septic shock (mortality rate at 28 days, 56%; mean admission Simplified Acute Physiology Score II, 47), we first illustrated immunoparalysis by showing a severe diminished monocytic human leukocyte antigen (HLA)-DR expression. Afterward, compared with control values, we found in these patients a marked elevation of circulating CD4+CD25+ T cells that were also CD45RO+ and CD69- and overexpressed CTLA-4. Importantly, nonsurvivors (n = 9) presented prolonged lower monocytic HLA-DR expression and higher percentage of CD4+CD25+ T-suppressor T cells.ConclusionsThese data support the concept that the persistence of a pronounced immunoparalysis after septic shock is associated with a poor outcome. Whether CD4+CD25+ T cells directly participate in sepsis-induced immunoparalysis remains to be investigated.
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