title: Associations of T helper 1, 2, 17 and regulatory T lymphocytes with mortality in severe sepsis.
abstract: OBJECTIVE
  T helper 17 (Th17) and regulatory T (Treg) lymphocytes might play important roles in patients with severe sepsis. The association of Th17 or Treg lymphocytes with survival is also unclear.
  
  
  METHODS
  Eighty-seven patients with severe sepsis were enrolled from our intensive care units between August 2008 and July 2010. Leukocyte antigens and clinical data were determined on day 1 in all patients and on day 7 in first-year patients.
  
  
  RESULTS
  The percentages in peripheral blood mononuclear cells (PBMCs) and circulatory counts of CD4⁺ and CD8⁺ lymphocytes in survivors were higher than those in non-survivors. Th1/CD4⁺ ratios and circulatory Th1 lymphocyte counts in survivors were higher than in non-survivors. Absolute counts of Th17 and Treg lymphocytes in survivors were higher than in non-survivors. The percentages of CD4⁺ and CD8⁺ in survivors' PBMCs were increased after 6 days. Th17/CD4⁺ ratios and circulatory Th17 lymphocyte counts in survivors were increased after 6 days.
  
  
  CONCLUSIONS
  Higher Th1 differentiation and total CD4⁺ T lymphocyte counts were associated with higher survival. The association of circulatory Th17 and Treg lymphocytes with mortality in severe sepsis may be due to the change in total CD4⁺ T lymphocytes. In survivors, Th17 differentiation and counts were restored.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan ROC.
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Wu
authors.forename: Kong
authors.initials: K
authors.lastname: Chung
authors.forename: Chun-Yao
authors.initials: CY
authors.lastname: Lin
authors.forename: Bor-Yiing
authors.initials: BY
authors.lastname: Jiang
authors.forename: Duen-Yau
authors.initials: DY
authors.lastname: Chuang
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Liu
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000276:immunology / Q000401:mortality*; D016176:T-Lymphocyte Subsets / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*