title: Early alterations of B cells in patients with septic shock.
abstract: BACKGROUND
  It has recently been proposed that B lymphocytes are involved in sepsis pathogenesis. The goal of this study is to investigate potential abnormalities in a subset distribution and activation of circulating B lymphocytes in patients with septic shock.
  
  
  METHODS
  This observational prospective study was conducted in a medical-surgical ICU. All patients with septic shock were eligible for inclusion. B-cell phenotypes (CD19+CD69+, CD19+CD23+, CD19+CD5+, CD19+CD80, CD19+CD86+, CD19+CD40 and CD19+CD95+) were assessed by quantitative flow cytometry upon admission to the ICU and 3, 7, 14 and 28 d later.
  
  
  RESULTS
  Fifty-two patients were included. Thirty-six healthy volunteers matched for age and sex were used as controls. The patients had lymphopenia that was maintained during 28 d of follow-up. In patients with septic shock who died, the percentage of CD19+CD23+ was lower during the 7 d of follow-up than it was in survival patients. Moreover, the percentage of CD80+ and CD95+ expression on B cells was higher in patients who died than in survivors. Receiver operating characteristic curve analysis showed that a CD19+CD23+ value of 64.6% at ICU admission enabled discrimination between survivors and nonsurvivors with a sensitivity of 90.9% and a specificity of 80.0% (P=0.0001).
  
  
  CONCLUSIONS
  Patients with septic shock who survive and those who don't have different patterns of abnormalities in circulating B lymphocytes. At ICU admission, a low percentage of CD23+ and a high of CD80+ and CD95+ on B cells were associated with increased mortality of patients with septic shock. Moreover, a drop in circulating B cells persisted during 28 d of ICU follow-up.
authors.forename: Jorge
authors.initials: J
authors.lastname: Monserrat
authors.forename: Raul
authors.initials: R
authors.lastname: de Pablo
authors.forename: David
authors.initials: D
authors.lastname: Diaz-Martín
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Zapata
authors.forename: Antonio
authors.initials: A
authors.lastname: de la Hera
authors.forename: Alfredo
authors.initials: A
authors.lastname: Prieto
authors.forename: Melchor
authors.initials: M
authors.lastname: Alvarez-Mon
mesh_terms: D000368:Aged; D001402:B-Lymphocytes / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D015996:Survival Rate / Q000639:trends; D013997:Time Factors