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Critical Care
Published in: Critical Care 6/2006

Open Access 01-12-2006 | Research

Early changes of CD4-positive lymphocytes and NK cells in patients with severe Gram-negative sepsis

Authors: Evangelos J Giamarellos-Bourboulis, Thomas Tsaganos, Ekaterini Spyridaki, Maria Mouktaroudi, Diamantis Plachouras, Ilia Vaki, Vassiliki Karagianni, Anastasia Antonopoulou, Vassiliki Veloni, Helen Giamarellou

Published in: Critical Care | Issue 6/2006

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Abstract

Introduction

Our aim was to define early changes of lymphocytes and of NK cells in severe sepsis and to correlate them with serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1).

Methods

Blood was sampled from 49 patients with proven highly suspected infection by Gram-negative pathogens, within 12 hours of the advent of severe sepsis, and was also sampled from six healthy volunteers. White blood cells were targeted with monoclonal antibodies and were analyzed by flow cytometry. The concentrations of sTREM-1 were estimated by ELISA.

Results

The presence of CD3/CD4 cells was significantly lower (P < 0.0001) and that of NK cells significantly higher among patients with sepsis compared with controls (P = 0.011). The proportions (median ± standard error) of ANNEXIN-V/CD4/CD3-positive cells, of ANNEXIN-V/CD8/CD3-positive cells and of ANNEXIN-V/CD14-positive cells of the patient population were 7.41 ± 2.26%, 7.69 ± 3.42% and 1.96 ± 4.22%, respectively. Patients with NK cells >20% survived longer compared with those patients with NK cells ≤20% (P = 0.041), and patients with sTREM-1 concentrations >180 pg/ml survived longer compared with those patients with sTREM-1 concentrations ≤180 pg/ml (P = 0.042). A negative correlation was found between the percentages of ANNEXIN-V/CD4/CD3-positive cells and of CD3/CD4 cells (rs = -0.305, P = 0.049), and a positive correlation was found between the serum sTREM-1 concentration and the percentage of NK cells (rs = +0.395, P = 0.014). NK cells isolated from two healthy volunteers released sTREM-1 upon triggering with endotoxins.

Conclusion

Early severe sepsis is characterized by CD4-lymphopenia and increased NK cells, providing a survival benefit for the septic patient at percentages >20%. The survival benefit resulting from elevated NK cells might be connected to elevated serum levels of sTREM-1.
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Metadata
Title
Early changes of CD4-positive lymphocytes and NK cells in patients with severe Gram-negative sepsis
Authors
Evangelos J Giamarellos-Bourboulis
Thomas Tsaganos
Ekaterini Spyridaki
Maria Mouktaroudi
Diamantis Plachouras
Ilia Vaki
Vassiliki Karagianni
Anastasia Antonopoulou
Vassiliki Veloni
Helen Giamarellou
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 6/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5111

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