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Alterations of T Helper Lymphocyte Subpopulations in Sepsis, Severe Sepsis, and Septic Shock: A Prospective Observational Study

Inflammation volume 38, pages 995–1002 (2015)Cite this article

ABSTRACT

Circulating lymphocyte number was significantly decreased in patients with sepsis. However, it remains unknown which severity phase (sepsis, severe sepsis, and septic shock) does it develop and what happen on each subpopulation. Eight patients with differing severities of sepsis (31 sepses, 33 severe sepses, and 16 septic shocks) were enrolled. Quantitative real-time polymerase chain reaction (RT-PCR) of Th1, Th2, and Th17; regulatory T (Treg) cell-specific transcription factor T-bet; GATA-3; RORgammat (RORγt); forkhead box P3 (FOXP3); and IL-17 mRNA were performed, and the enzyme-linked immunosorbent assay (ELISA) was used to detect serum interferon (IFN)-γ, IL-4, and IL-10. In this study, the Th1, Th2, Treg transcription factors, and related cytokines IFN-γ, IL-4, and IL-10 levels of sepsis and severe sepsis patients in peripheral blood were significantly higher than those of the normal controls. Except for IL-17, the T-bet, GATA-3, and IFN-γ levels of septic shock patients were lower than those of sepsis patients. We also observed that the proportions of Th17/Treg in the sepsis and septic shock groups were inversed. From the above, the inflammatory response especially the adaptive immune response is still activated in sepsis and severe sepsis, but significant immunosuppression was developed in septic shock. In addition, the proportion of Th17/Treg inversed may be associated with the illness aggravation of patients with sepsis.

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ACKNOWLEDGMENTS

This study was supported by the Beijing Municipal Science & Technology Commission Program (program number Z11110706730000, project number Z111107067311029) and the National Natural Sciences Foundation of China (Grant No.81172800). The authors thank the nurses of RICU/SICU/EICU at the Chinese PLA General Hospital for their work in this study.

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Affiliations

  1. Department of Respiratory Medicine, the Chinese PLA General Hospital, NO.28 Fuxing Road, Haidian District, 100853, Beijing, China

    Jia Li, Kun Xiao, Jie Deng, Yanhong Jia & Lixin Xie

  2. School of medicine, Nankai University, Tianjin, China

    Jia Li

  3. Department of Respiratory Medicine, People’s Hospital of Tianjin, Tianjin, China

    Ming Li

  4. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China

    Longxiang Su

  5. Respiratory Medicine Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    Huijuan Wang

  6. Department of Immunology, Beijing Institute of Basic Medical Sciences, Beijing, 100850, China

    Gencheng Han

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  1. Jia Li
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  2. Ming Li
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  3. Longxiang Su
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  4. Huijuan Wang
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  5. Kun Xiao
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  6. Jie Deng
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  7. Yanhong Jia
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  8. Gencheng Han
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  9. Lixin Xie
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Corresponding authors

Correspondence to Gencheng Han or Lixin Xie.

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Jia Li and Ming Li contributed equally to this work and should be considered co-first authors.

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Li, J., Li, M., Su, L. et al. Alterations of T Helper Lymphocyte Subpopulations in Sepsis, Severe Sepsis, and Septic Shock: A Prospective Observational Study. Inflammation 38, 995–1002 (2015). https://doi.org/10.1007/s10753-014-0063-3

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KEY WORDS

  • septic shock
  • lymphocytes
  • T-bet
  • GATA-3
  • RORγt
  • FOXP3