1. Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection
- Author
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Gogos, Charalambos Kotsaki, Antigone Pelekanou, Aimilia and Giannikopoulos, George Vaki, Ilia Maravitsa, Panagiota and Adamis, Stephanos Alexiou, Zoi Andrianopoulos, George and Antonopoulou, Anastasia Athanassia, Sofia Baziaka, Fotini and Charalambous, Aikaterini Christodoulou, Sofia Dimopoulou, Ioanna and Floros, Ioannis Giannitsioti, Efthymia Gkanas, Panagiotis and Ioakeimidou, Aikaterini Kanellakopoulou, Kyriaki Karabela, Niki Karagianni, Vassiliki Katsarolis, Ioannis Kontopithari, Georgia Kopterides, Petros Koutelidakis, Ioannis Koutoukas, Pantelis Kranidioti, Hariklia Lignos, Michalis Louis, Konstantinos Lymberopoulou, Korina Mainas, Efstratios and Marioli, Androniki Massouras, Charalambos Mavrou, Irini and Mpalla, Margarita Michalia, Martha Mylona, Heleni Mytas, Vassilios Papanikolaou, Ilias Papanikolaou, Konstantinos and Patrani, Maria Perdios, Ioannis Plachouras, Diamantis and Pistiki, Aikaterini Protopapas, Konstantinos Rigaki, Kalliopi and Sakka, Vissaria Sartzi, Monika Skouras, Vassilios Souli, Maria Spyridaki, Aikaterini Strouvalis, Ioannis Tsaganos, Thomas Zografos, George Mandragos, Konstantinos and Klouva-Molyvdas, Phylis Maggina, Nina Giamarellou, Helen and Armaganidis, Apostolos Giamarellos-Bourboulis, Evangelos J.
- 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