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Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection

机译：根据潜在感染的类型，脓毒症先天性和适应性免疫状态的早期改变

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IntroductionAlthough 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.MethodsThe 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.ResultsExpression 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.ConclusionsMajor 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.
机译：简介尽管在脓毒症中已描述了免疫系统的重大变化，但从未对这些变化是否与潜在感染类型相关进行过研究。方法505例患者前瞻性比较了先天性和适应性免疫系统的状况。在败血症出现后不到24小时内取样全血;结果急性肾盂肾炎和腹腔内感染引起的严重脓毒症/休克患者与脓毒症相比，HLA-DR的表达显着降低。与败血症相比，由于呼吸机相关性肺炎（VAP）和医院获得性肺炎（HAP）导致的严重脓毒症/休克患者的自然杀伤（NK）细胞凋亡率显着不同。与脓毒症相比，由于急性肾盂肾炎，原发菌血症和VAP / HAP导致的严重脓毒症/休克患者的NKT细胞凋亡率显着不同。关于适应性免疫，与脓毒症相比，由于社区获得性肺炎（CAP）和腹腔内感染而导致的严重脓毒症/休克患者中CD4淋巴细胞的绝对计数显着降低。与脓毒症相比，CAP引起的严重脓毒症/休克患者B淋巴细胞绝对计数显着降低。感染。这些结果可能对治疗产生重大影响。

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