Alterations of T Helper Lymphocyte Subpopulations in Sepsis, Severe Sepsis, and Septic Shock: A Prospective Observational Study
Alterations of T Helper Lymphocyte Subpopulations in Sepsis, Severe Sepsis, and Septic Shock: A Prospective Observational Study
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DOI：
10.1007/s10753-014-0063-3
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发表时间：
2015-06-01
期刊：
影响因子：
5.1
通讯作者：
Xie, Lixin
中科院分区：
文献类型：
--
作者：
Li, Jia;Li, Ming;Xie, Lixin
脓毒症患者循环淋巴细胞数量明显减少。然而，目前尚不清楚它会发展到哪个严重阶段（脓毒症，严重脓毒症和脓毒性休克）以及每个亚群会发生什么。入选了8例不同严重程度的脓毒症患者（31例脓毒症，33例严重脓毒症和16例脓毒性休克）。对Th 1、Th 2和Th 17;调节性T（Treg）细胞特异性转录因子T-bet;加塔-3; ROR gammat（ROR gamma t）;叉头盒P3（FOXP 3）和IL-17 mRNA进行定量实时聚合酶链反应（RT-PCR），并使用酶联免疫吸附试验（ELISA）检测血清干扰素（IFN）-γ、IL-4和IL-10。本研究中，脓毒症和严重脓毒症患者外周血中Th 1、Th 2、Treg转录因子及相关细胞因子IFN-γ、IL-4、IL-10水平均显著高于正常对照组。除IL-17外，感染性休克患者的T-bet、加塔-3和IFN-γ水平均低于脓毒症患者。我们还观察到脓毒症组和脓毒性休克组的Th 17/Treg比例是相反的。由此可见，脓毒症和严重脓毒症时炎症反应尤其是适应性免疫反应仍处于激活状态，而脓毒症休克时则出现明显的免疫抑制。此外，Th 17/Treg比例倒置可能与脓毒症患者病情加重有关。
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 (ROR gamma t); forkhead box P3 (FOXP3); and IL-17 mRNA were performed, and the enzyme-linked immunosorbent assay (ELISA) was used to detect serum interferon (IFN)-gamma, IL-4, and IL-10. In this study, the Th1, Th2, Treg transcription factors, and related cytokines IFN-gamma, 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-gamma 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.