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Altered T-lymphocyte subsets in severe sepsis.
M S Dahn1, M P Whitcomb, M P Lange
1Department of Surgery and Immunology, V.A. Medical Center, Allen Park, Michigan.
The American Surgeon
|July 1, 1988
Summary
Immune response in surgical patients can be predicted by analyzing T-cell subsets. Survivors of sepsis maintain normal T-cell levels, while nonsurvivors show a decline in helper T-cells, indicating a poor prognosis.
Area of Science:
- Immunology
- Surgical Critical Care
Background:
- Sepsis and surgical injury significantly impact the immune system.
- Understanding immune response is crucial for predicting patient outcomes.
Purpose of the Study:
- To investigate the immune response in surgical patients following injury and sepsis.
- To determine if T-cell subset analysis can predict patient prognosis.
Main Methods:
- Measured total lymphocyte counts and T-cell subsets (helper OKT4, suppressor OKT8) in septic and nonseptic patients.
- Analyzed T-cell subpopulations and helper to suppressor cell ratios in relation to patient survival.
Main Results:
- Total lymphocyte and T-cell levels decreased similarly in both injury and sepsis, lacking prognostic value.
- Septic survivors showed normal T-cell subpopulations and helper to suppressor ratios.
- Septic nonsurvivors exhibited a selective depression of helper (OKT4) T-cells, with ratio decline correlating to mortality.
- A helper to suppressor ratio below 0.6 was a consistent indicator of a fatal outcome.
- Some septic nonsurvivors also showed a selective depression of suppressor (OKT8) lymphocytes, indicating an unfavorable prognosis.
Conclusions:
- T-lymphocyte subpopulation analysis, particularly the helper to suppressor ratio, is a valuable predictor of hospital course in septic patients.
- Monitoring T-cell subsets can aid in assessing prognosis and guiding clinical management.