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Published on: April 11, 2012
Associations of T helper 1, 2, 17 and regulatory T lymphocytes with mortality in severe sepsis
Huang-Pin Wu1, Kong Chung, Chun-Yao Lin
1Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan ROC.
Objective And Design:
T helper 17 (Th17) and regulatory T (Treg) lymphocytes might play important roles in patients with severe sepsis. The association of Th17 or Treg lymphocytes with survival is also unclear.
Methods:
Eighty-seven patients with severe sepsis were enrolled from our intensive care units between August 2008 and July 2010. Leukocyte antigens and clinical data were determined on day 1 in all patients and on day 7 in first-year patients.
Results:
The percentages in peripheral blood mononuclear cells (PBMCs) and circulatory counts of CD4⁺ and CD8⁺ lymphocytes in survivors were higher than those in non-survivors. Th1/CD4⁺ ratios and circulatory Th1 lymphocyte counts in survivors were higher than in non-survivors. Absolute counts of Th17 and Treg lymphocytes in survivors were higher than in non-survivors. The percentages of CD4⁺ and CD8⁺ in survivors' PBMCs were increased after 6 days. Th17/CD4⁺ ratios and circulatory Th17 lymphocyte counts in survivors were increased after 6 days.
Conclusions:
Higher Th1 differentiation and total CD4⁺ T lymphocyte counts were associated with higher survival. The association of circulatory Th17 and Treg lymphocytes with mortality in severe sepsis may be due to the change in total CD4⁺ T lymphocytes. In survivors, Th17 differentiation and counts were restored.
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