Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection

Gogos, Charalambos; Kotsaki, Antigone; Πελεκάνου, Αιμιλία; Giannikopoulos, George; Vaki, Ilia; Maravitsa, Panagiota; Adamis, Stephanos; Alexiou, Zoi; Andrianopoulos, George; Antonopoulou, Anastasia; Athanassia, Sofia; Baziaka, Fotini; Charalambous, Aikaterini; Christodoulou, Sofia; Dimopoulou, Ioanna; Floros, Ioannis; Giannitsioti, Efthymia; Gkanas, Panagiotis; Ioakeimidou, Aikaterini; Kanellakopoulou, Kyriaki; Karabela, Niki; Karagianni, Vassiliki; Katsarolis, Ioannis; Kontopithari, Georgia; Kopterides, Petros; Koutelidakis, Ioannis; Koutoukas, Pantelis; Kranidioti, Hariklia; Lignos, Michalis; Louis, Konstantinos; Lymberopoulou, Korina; Mainas, Efstratios; Marioli, Androniki; Massouras, Charalambos; Mavrou, Irini; Mpalla, Margarita; Michalia, Martha; Mylona, Heleni; Mytas, Vassilios; Papanikolaou, Ilias; Παπανικολάου, Κωνσταντίνος; Patrani, Maria; Perdios, Ioannis; Plachouras, Diamantis; Pistiki, Aikaterini; Protopapas, Konstantinos; Rigaki, Kalliopi; Sakka, Vissaria; Sartzi, M; Skouras, Vasileios; Souli, Maria; Spyridaki, Aikaterini; Strouvalis, Ioannis; Τσαγανός, Θωμάς; Zografos, George; Mandragos, Konstantinos; Klouva-Molyvdas, Phylis; Maggina, Nina; Giamarellou, Helen; Armaganidis, Apostolos

doi:10.1186/cc9031

Cited by 114 publications

(103 citation statements)

References 26 publications

(29 reference statements)

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“…This should be taken into thorough consideration for the successful clinical development and application of immunomodulators. A c c e p t e d M a n u s c r i p t M a n u s c r i p t A c c e p t e d M a n u s c r i p t Table 1 Early changes of innate and adaptive immunity in a cohort of 505 Greek patients during transition from sepsis to severe sepsis/shock in relation to the underlying type of infection (modified by [21] …”

Section: Discussionmentioning

confidence: 99%

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What is the pathophysiology of the septic host upon admission?

Giamarellos‐Bourboulis

2010

International Journal of Antimicrobial Agents

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The enormous case-fatality rate of severe sepsis and septic shock has resulted in considerable efforts being made towards understanding their complex mechanisms of pathogenesis. This has been done with the hope that agents that interfere with the pathways of pathogenesis and modulate the immune response of the host may be candidates for therapy. Disappointing results from most trials of immunomodulators in sepsis have led to understanding that the progression of patients to multiple organ dysfunction syndrome involves blunting of the pro-inflammatory cytokine storm. responses. CARS is not the sole explanation for the failure of trials of immunomodulators in sepsis. Recent data from the Hellenic Sepsis Study Group demonstrate that components of CARS upon transition from sepsis to severe sepsis/shock differ in relation to the underlying type of infection. These data underscore that the pathogenesis of sepsis presents considerable heterogeneity from one patient to another. That heterogeneity should be taken into consideration when deciding to administer an immunomodulator.

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Section: Discussionmentioning

confidence: 99%

“…In an attempt to resolve this, the Hellenic Sepsis Study Group studied the early status of the innate and adaptive immune responses among a large number of septic patients [21]. Blood samples were prospectively collected from 505 patients within 24 h of the clinical presentation of sepsis.…”

Section: The Problem Of Patient Heterogeneitymentioning

confidence: 99%

What is the pathophysiology of the septic host upon admission?

Giamarellos‐Bourboulis

2010

International Journal of Antimicrobial Agents

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“…Decreased mHLA-DR levels could predict poor outcome and septic Kojic D et al . A review "from bench to bedside" complications after trauma, surgery, burn, pancreatitis and septic shock [86][87][88][89] but there is few knowledge about the underlying mechanisms [90] . A prospective randomised placebo-controlled trial used mHLA-DR to stratify the administration of granulocytemacrophage colony-stimulating factor (GM-CSF) in a small group of septic patients.…”

Section: Human Leukocyte Antigen-dr On Circulating Monocytesmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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“…The analysis of peripheral blood leukocytes reflects either their turn-over or their translocation from circulation to the tissues and reverse. In a recent paper, Gogos et al [8] showed similar rates of monocyte apoptosis in sepsis derived from peritonitis, CAP and VAP. Given this, our results suggest a translocation of monocyte population to the inflamed lungs in PDS which is consistent with the experimental data.…”

Section: Discussionmentioning

confidence: 99%

“…We focused on patients in septic shock who were in a critical state. To the best of our knowledge, there has previously only been one paper focusing on the early cellular response in sepsis derived from different sites [8].…”

Section: Introductionmentioning

confidence: 99%

Absolute counts of peripheral blood leukocyte subpopulations in intraabdominal sepsis and pneumonia-derived sepsis: a pilot study

Hoser¹,

Skirecki²,

Złotorowicz³

et al. 2012

Folia Histochem Cytobiol.

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Abstract:The leading pathophysiological changes during sepsis include systemic abnormalities in the immune response. Due to the general character of these disturbances, sepsis is usually studied as a homogenous clinical condition. We aimed to compare the immune response in intraabdominal sepsis (IAS) and pneumonia-derived sepsis (PDS). The following cell populations were examined: white blood cell count (WBC), monocytes, lymphocytes: CD3 + , CD4+ and CD8 + T cells, B cells, and NK cells. In both studied groups (i.e. IAS and PDS), the WBC was elevated. However, it was significantly higher in the IAS group than in the PDS group. The difference was due to a lower granulocyte count, as well as a lower monocyte count in PDS. We found no significant correlation between the total lymphocyte number and CD3 + CD8 + T cells in either form of sepsis. Similarly, we observed no correlation between the total lymphocyte number and the NK cells subset in IAS. However, the numbers of CD3 + CD8+ and NK cells correlated similarly in both types of sepsis. Both studied types of sepsis induced profound lymphocytopenia, with marked loss of CD8 + T cells and the NK cells. However, the similar relation between them, which was independent of the infection type, suggests that the NK and CD3 + CD8+ cells have shared mechanisms of regulation. The primary site of infection has an impact on the global immune reaction. These alternations include especially myeloid cells: granulocytes and monocytes which disappear from peripheral blood during PDS, but increase in IAS.

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Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection

Cited by 114 publications

References 26 publications

What is the pathophysiology of the septic host upon admission?

What is the pathophysiology of the septic host upon admission?

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Absolute counts of peripheral blood leukocyte subpopulations in intraabdominal sepsis and pneumonia-derived sepsis: a pilot study

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