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Published on: June 15, 2019
Sepsis induces early alterations in innate immunity that impact mortality to secondary infection
Matthew J Delano1, Terri Thayer, Sonia Gabrilovich
1Department of Surgery, College of Medicine, University of Florida Health Science Center, Gainesville, FL 32610, USA.
Abstract:
Sepsis, the systemic inflammatory response to microbial infection, induces changes in both innate and adaptive immunity that presumably lead to increased susceptibility to secondary infections, multiorgan failure, and death. Using a model of murine polymicrobial sepsis whose severity approximates human sepsis, we examined outcomes and defined requirements for survival after secondary Pseudomonas aeruginosa pneumonia or disseminated Listeria monocytogenes infection. We demonstrate that early after sepsis neutrophil numbers and function are decreased, whereas monocyte recruitment through the CCR2/MCP-1 pathway and function are enhanced. Consequently, lethality to Pseudomonas pneumonia is increased early but not late after induction of sepsis. In contrast, lethality to listeriosis, whose eradication is dependent upon monocyte/macrophage phagocytosis, is actually decreased both early and late after sepsis. Adaptive immunity plays little role in these secondary infectious responses. This study demonstrates that sepsis promotes selective early, impaired innate immune responses, primarily in neutrophils, that lead to a pathogen-specific, increased susceptibility to secondary infections.
Insights
Sepsis impairs neutrophil function, increasing susceptibility to secondary bacterial pneumonia. However, it enhances monocyte responses, reducing susceptibility to Listeria infections.
Area of Science:
- Immunology
- Infectious Diseases
- Microbiology
Background:
- Sepsis, a life-threatening systemic inflammatory response to infection, alters immune function.
- This immune dysregulation is thought to increase susceptibility to subsequent infections and organ failure.
Purpose of the Study:
- To investigate how sepsis affects susceptibility to distinct secondary infections.
- To define the immune mechanisms underlying these altered susceptibilities.
Main Methods:
- A murine model of polymicrobial sepsis was used.
- Mice were subsequently infected with Pseudomonas aeruginosa (pneumonia) or Listeria monocytogenes (disseminated).
- Immune cell populations (neutrophils, monocytes) and survival rates were assessed.
Main Results:
- Early after sepsis, neutrophil numbers and function were reduced, increasing mortality from P. aeruginosa pneumonia.
- Monocyte recruitment and function were enhanced via the CCR2/MCP-1 pathway.
- Mortality from L. monocytogenes infection, dependent on monocytes/macrophages, was decreased post-sepsis.
Conclusions:
- Sepsis causes pathogen-specific alterations in innate immunity.
- Early neutrophil impairment drives increased susceptibility to certain secondary bacterial infections.
- Enhanced monocyte function may offer protection against other infections like listeriosis.
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