Skip to main content
Top
Published in: Intensive Care Medicine 1/2007

01-01-2007 | Brief Report

Decrease in circulating dendritic cells predicts fatal outcome in septic shock

Authors: Olivier Guisset, Marie-Sarah Dilhuydy, Rodolphe Thiébaut, Jérôme Lefèvre, Fabrice Camou, Anne Sarrat, Claude Gabinski, Jean-François Moreau, Patrick Blanco

Published in: Intensive Care Medicine | Issue 1/2007

Login to get access

Abstract

Objective

Biomarkers allowing accurate early staging of septic shock patients are lacking despite their obvious interest for patient management. Experimental models of septic shock in mouse previously noted a decrease in dendritic cell numbers. The aim of the study was to find a rapid reproducible biological test for an assessment of disease severity.

Design

Evaluation of peripheral blood dendritic cell counts by flow cytometry using three commercially available kits.

Patients and participants

Forty-two consecutive septic shock patients were studied prospectively.

Measurements and results

Early low dendritic cell counts were correlated to disease severity as assessed by Simplified Acute Physiology Score or Sequential Organ Failure Assessment and predicted fatal outcome. The correlation was still present when the results were adjusted for age.

Conclusion

The monitoring of blood dendritic cell count may provide an early and valuable assessment of the severity of the host response against infection and may influence the therapeutic management of septic shock patients.
Literature
1.
go back to reference Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310PubMedCrossRef Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310PubMedCrossRef
2.
3.
go back to reference Hotchkiss RS, Karl IE (2003) The pathophysiology and treatment of sepsis. N Engl J Med 348:138–150PubMedCrossRef Hotchkiss RS, Karl IE (2003) The pathophysiology and treatment of sepsis. N Engl J Med 348:138–150PubMedCrossRef
4.
go back to reference Banchereau J, Steinman RM (1998) Dendritic cells and the control of immunity. Nature 392:245–252PubMedCrossRef Banchereau J, Steinman RM (1998) Dendritic cells and the control of immunity. Nature 392:245–252PubMedCrossRef
5.
go back to reference Zou W (2005) Immunosuppressive networks in the tumour environment and their therapeutic relevance. Nat Rev Cancer 5:263–274PubMedCrossRef Zou W (2005) Immunosuppressive networks in the tumour environment and their therapeutic relevance. Nat Rev Cancer 5:263–274PubMedCrossRef
6.
go back to reference Blanco P, Palucka AK, Gill M, Pascual V, Banchereau J (2001) Induction of dendritic cell differentiation by IFN-alpha in systemic lupus erythematosus. Science 294:1540–1543PubMedCrossRef Blanco P, Palucka AK, Gill M, Pascual V, Banchereau J (2001) Induction of dendritic cell differentiation by IFN-alpha in systemic lupus erythematosus. Science 294:1540–1543PubMedCrossRef
7.
go back to reference Pulendran B, Palucka K, Banchereau J (2001) Sensing pathogens and tuning immune responses. Science 293:253–256PubMedCrossRef Pulendran B, Palucka K, Banchereau J (2001) Sensing pathogens and tuning immune responses. Science 293:253–256PubMedCrossRef
8.
go back to reference Efron PA, Martins A, Minnich D, Tinsley K, Ungaro R, Bahjat FR, Hotchkiss R, Clare-Salzler M, Moldawer LL (2004) Characterization of the systemic loss of dendritic cells in murine lymph nodes during polymicrobial sepsis. J Immunol 173:3035–3043PubMed Efron PA, Martins A, Minnich D, Tinsley K, Ungaro R, Bahjat FR, Hotchkiss R, Clare-Salzler M, Moldawer LL (2004) Characterization of the systemic loss of dendritic cells in murine lymph nodes during polymicrobial sepsis. J Immunol 173:3035–3043PubMed
9.
go back to reference Hotchkiss RS, Tinsley KW, Swanson PE, Grayson MH, Osborne DF, Wagner TH, Cobb JP, Coopersmith C, Karl IE (2002) Depletion of dendritic cells, but not macrophages, in patients with sepsis. J Immunol 168:2493–2500PubMed Hotchkiss RS, Tinsley KW, Swanson PE, Grayson MH, Osborne DF, Wagner TH, Cobb JP, Coopersmith C, Karl IE (2002) Depletion of dendritic cells, but not macrophages, in patients with sepsis. J Immunol 168:2493–2500PubMed
10.
go back to reference Tinsley KW, Grayson MH, Swanson PE, Drewry AM, Chang KC, Karl IE, Hotchkiss RS (2003) Sepsis induces apoptosis and profound depletion of splenic interdigitating and follicular dendritic cells. J Immunol 171:909–914PubMed Tinsley KW, Grayson MH, Swanson PE, Drewry AM, Chang KC, Karl IE, Hotchkiss RS (2003) Sepsis induces apoptosis and profound depletion of splenic interdigitating and follicular dendritic cells. J Immunol 171:909–914PubMed
11.
go back to reference Riedemann NC, Guo RF, Ward PA (2003) Novel strategies for the treatment of sepsis. Nat Med 9:517–524PubMedCrossRef Riedemann NC, Guo RF, Ward PA (2003) Novel strategies for the treatment of sepsis. Nat Med 9:517–524PubMedCrossRef
12.
go back to reference Wysocka M, Montaner LJ, Karp CL (2005) Flt3 ligand treatment reverses endotoxin tolerance-related immunoparalysis. J Immunol 174:7398–7402PubMed Wysocka M, Montaner LJ, Karp CL (2005) Flt3 ligand treatment reverses endotoxin tolerance-related immunoparalysis. J Immunol 174:7398–7402PubMed
Metadata
Title
Decrease in circulating dendritic cells predicts fatal outcome in septic shock
Authors
Olivier Guisset
Marie-Sarah Dilhuydy
Rodolphe Thiébaut
Jérôme Lefèvre
Fabrice Camou
Anne Sarrat
Claude Gabinski
Jean-François Moreau
Patrick Blanco
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 1/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0436-7

Other articles of this Issue 1/2007

Intensive Care Medicine 1/2007 Go to the issue

Mini series: Basic research-related topics in ICM

Lipoproteins in inflammation and sepsis. II. Clinical aspects