title: Prognostic value of CD4(+)CD25(+) Tregs as a valuable biomarker for patients with sepsis in ICU.
abstract: BACKGROUND
  Sepsis is a common complication of infections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4(+)CD25(+) regulatory T cells (Treg) in peripheral blood of patients with sepsis.
  
  
  METHODS
  Periphery blood from 28 patients diagnosed with sepsis was collected on day 1 and 7 after hospitalization in the ICU of Shanghai Changzheng Hospital between December 2013 to April 2014. The blood was used for analyses of Treg ratio using flow cytometry and for analyses of blood routine test, C-reactive protein (CRP), bilirubin, procalcitonin (PCT), and coagulation. APACHE II and sequential organ failure assessment (SOFA) scores were also investigated. The results were compared between two outcome groups of survival or death to evaluate prognostic value for sepsis.
  
  
  RESULTS
  The patients had an average age of 60.36±15.03 years, APACHE II score 16.68±7.00, and SOFA score 7.18±3.78. Among the 28 patients, 12 had severe trauma (42.9%), 10 had septic shock (35.7%), and 9 (32.2%) died. The median ratio of Tregs was 2.10% (0.80%, 3.10%) in the survival group vs. 1.80% (1.15%, 3.65%) in the death group (Z=-0.148, P=0.883) on day 1; however it was significantly changed to 0.90% (0.30%, 2.80%) vs. 5.70% (2.60%, 8.30%) (Z=-2.905, P=0.004).
  
  
  CONCLUSIONS
  With better prospects for clinical application, dynamic monitoring of Tregs ratio in peripheral blood has potential value in predicting prognosis of sepsis.
authors: Emergency Department, Changzheng Hospital, Second Military Medical Univercity, Shanghai 200003, China.
authors: Kun
authors: K
authors: Chen
authors: Emergency Department, Changzheng Hospital, Second Military Medical Univercity, Shanghai 200003, China.
authors: Qiu-Xiang
authors: QX
authors: Zhou
authors: Emergency Department, Changzheng Hospital, Second Military Medical Univercity, Shanghai 200003, China.
authors: Hong-Wei
authors: HW
authors: Shan
authors: Emergency Department, Changzheng Hospital, Second Military Medical Univercity, Shanghai 200003, China.
authors: Wen-Fang
authors: WF
authors: Li
authors: Emergency Department, Changzheng Hospital, Second Military Medical Univercity, Shanghai 200003, China.
authors: Zhao-Fen
authors: ZF
authors: Lin
keywords: APACHE; Biomarker; CD4+CD25+ regulatory T cells; Procalcitonin; Prognosis; SOFA; Sepsis