Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection.
BACKGROUND
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.
Gogos
Charalambos
C
1st Department of Internal Medicine, University of Patras, Medical School, 26504 Rio, Greece. cgogos@med.upatras.gr
Kotsaki
Antigone
A
Pelekanou
Aimilia
A
Giannikopoulos
George
G
Vaki
Ilia
I
Maravitsa
Panagiota
P
Adamis
Stephanos
S
Alexiou
Zoi
Z
Andrianopoulos
George
G
Antonopoulou
Anastasia
A
Athanassia
Sofia
S
Baziaka
Fotini
F
Charalambous
Aikaterini
A
Christodoulou
Sofia
S
Dimopoulou
Ioanna
I
Floros
Ioannis
I
Giannitsioti
Efthymia
E
Gkanas
Panagiotis
P
Ioakeimidou
Aikaterini
A
Kanellakopoulou
Kyriaki
K
Karabela
Niki
N
Karagianni
Vassiliki
V
Katsarolis
Ioannis
I
Kontopithari
Georgia
G
Kopterides
Petros
P
Koutelidakis
Ioannis
I
Koutoukas
Pantelis
P
Kranidioti
Hariklia
H
Lignos
Michalis
M
Louis
Konstantinos
K
Lymberopoulou
Korina
K
Mainas
Efstratios
E
Marioli
Androniki
A
Massouras
Charalambos
C
Mavrou
Irini
I
Mpalla
Margarita
M
Michalia
Martha
M
Mylona
Heleni
H
Mytas
Vassilios
V
Papanikolaou
Ilias
I
Papanikolaou
Konstantinos
K
Patrani
Maria
M
Perdios
Ioannis
I
Plachouras
Diamantis
D
Pistiki
Aikaterini
A
Protopapas
Konstantinos
K
Rigaki
Kalliopi
K
Sakka
Vissaria
V
Sartzi
Monika
M
Skouras
Vassilios
V
Souli
Maria
M
Spyridaki
Aikaterini
A
Strouvalis
Ioannis
I
Tsaganos
Thomas
T
Zografos
George
G
Mandragos
Konstantinos
K
Klouva-Molyvdas
Phylis
P
Maggina
Nina
N
Giamarellou
Helen
H
Armaganidis
Apostolos
A
Giamarellos-Bourboulis
Evangelos J
EJ
D056704:Adaptive Immunity / Q000276:immunology*; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology; D018791:CD4 Lymphocyte Count; D005260:Female; D006115:Greece; D006684:HLA-DR Antigens / Q000097:blood; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology*; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000145:classification* / Q000276:immunology
D006684:HLA-DR Antigens