Objective To investigate the relationship between blood CD4 + CD25 + regulatory T cells ( Treg cells) and cell immunity in patients with sepsis and its prognostic value.Methods 27 patients with sepsis admitted during August 2007 and August 2008 in ICU were enrolled, while 40 healthy volunteers served as control. According to the clinical outcome after 28 days’ treatment, the sepsis patients were assigned to a death group( n=8) and a survival group ( n =19) . Blood Treg% and CD4 /CD8 were detected by flow cytometry and total AgNOR area/nucleus area per cell ( IS%) was measured by silver nitrate staining and image processing. Results The Treg% in the patients with sepsis was significant higher than that in the normal control [ ( 5. 61 ±1. 60) % vs. ( 0. 78 ±0. 23) % , P lt; 0. 01 ] , while the level of CD4 /CD8 and IS% were significant lower[ CD4 /CD8: ( 1. 09 ±0. 30) vs. ( 1. 71 ±0. 36) , IS% : ( 5. 19 ±1. 07) % vs. ( 6. 76 ±0. 92) % , both P lt; 0. 01] . Significant correlations were found between Treg% and CD4 /CD8( r= - 0. 484, P lt;0. 01) , and between Treg% and IS% ( r = - 0. 588, P lt;0. 01) . Compared with the survival group, Treg% was significant higher [ ( 7. 09 ±1. 17) % vs. ( 5. 00 ±1. 33) % , P lt; 0. 01] , and CD4 /CD8 and IS% were significant lower[ CD4 /CD8: ( 0. 87 ±0. 22) vs. ( 1. 18 ±0. 29) , IS% : ( 3. 97 ±0. 42) % vs. ( 5. 71 ±0. 81) % , both P lt; 0. 01] in the death group. Conlusion Blood Treg% level can reflect the cell immune state of patients with sepsis and is of clinical value to assess the prognosis.
Citation：
ZHANG Lina,WU Tiejun,LIU Zhijun.. Clinical Implications of Blood CD4 + CD25 + Regulatory T cells in Patients with Sepsis. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(4): 416-418. doi:
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- 1. Andrews P, Azoulay E, Antonelli M, et al. Year in review in Intensive Care Medicine, 2006. II. Infections and sepsis,haemodynamics, elderly, invasive and noninvasive mechanical ventilation, weaning, ARDS. Intensive Care Med, 2007, 33 : 214 -229.
- 2. 崔德健. 探讨脓毒症诊断和治疗新策略. 中国呼吸与危重监护杂志, 2004 , 3: 21 -24.
- 3. Shimizu J, Yamazaki S, Takahashi T, et al. Stimulation of CD25 +CD4 + regulatory T cells through GITR breaks immunological selftolerance.Nat Immunol, 2002, 3 : 135-142.
- 4. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS /SIS international sepsis definitions conference. Crit Care Med,2003, 31: 1250-1256 .
- 5. Sakaguchi S, Sakaguchi N, Asano M, et al. Immunologic selftolerance maintained by cell expressing IL-2 receptor alpha-chains ( CD25) .Breakdown of a single mechanism of self-tolerance causes various autoimmune disease. Immunol,1995, 155, 1151-1164.
- 6. Wisnoski N, Chung CS, Chen Y. The Contribution of CD4 + CD25 +T-Regulatory-Cells to immune suppression in sepsis. Shock, 2007 ,27: 251-257 .
- 7. Monneret G, Debard AL, Venet F, et al. Marked elevation of human circulating CD4 + CD25 + regulatory T cells in sepsis induced immunoparalysis. Crit Care Med, 2003, 31 : 2068 -2071.
- 8. Von Boehmer H. Mechanisms of suppression by suppressor T cells.Nat Immunol, 2005, 6: 338-344.
- 9. Venet F, Pachot A, Debard AL. Human CD4 + CD25 + Regulatory T lymphocytes inhibit lipopolysaccharide-induced monocyte survival through a Fas/ Fas ligand-dependent mechanism. J Immunol, 2006 ,177: 6540-6547.
- 10. Heuer JG, Zhang T, Zhao J, et al. Adoptive transfer of in vitro stimulated CD4 + CD25 + regulatory T cells increases bacterial clearance and improves survival in polymicrobial sepsis. J Immunol,2005, 174: 7141-7146.
