Immune profile of patients‑a new approach in management of sepsis and septic shock?

Abstract

The present study was a prospective observational single center study, enrolling 102 patients with sepsis, admitted in the Intensive Care Unit of the County Emergency Clinical Hospital in Târgu Mureș (Mureș, Romania). The main goal of the present study was to compare the changes of the following parameters on day 1 compared with day 5, in sepsis compared with septic shock, as well as in survivors compared with non-survivors: Cell blood count parameters, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic inflammation index, C reactive protein (CRP), ferritin, procalcitonin (PCT), CD 3+ T cells, CD4+ T cells, CD8+ T cells, CD16+CD56+/CD3-NK cells and CD19+ B cells. The relationship between the subcategories of lymphocytes with the inflammatory markers was evaluated. The serum concentration of CRP and PCT was significantly lower on day 5 compared with day 1 and serum ferritin was significantly higher in patients with septic shock. The percentage of cytotoxic T lymphocytes was significantly decreased and the percentage of NK lymphocytes was significantly increased in patients who developed septic shock. The results indicated a negative significant correlation between the proportion of T lymphocytes and PCT concentration and a positive significant correlation between the proportion of B lymphocytes and PCT concentration.

Predictive Value of Inflammatory Markers NLR, PLR, APRI, SII, and Liver Function Tests in Systemic Inflammatory Response Syndrome Detection in Full-Term Newborns

“…Mahmoud et al [26] reported high specificity and positive predictive value for the NLR and PLR in detecting early-onset neonatal sepsis (NLR 99% specificity, 98% PPV; PLR 73% specificity, 72% PPV), underscoring their utility as reliable indicators of sepsis in neonates. Similarly, Bacarea et al's [27] analysis in adult sepsis patients highlighted the prognostic significance of dynamic changes in the NLR and PLR, alongside systemic inflammation markers, reinforcing the potential of these biomarkers to reflect the severity and progression of sepsis.…”