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Early immune system alterations in patients with septic shock
Huiming Tang1, Shuang Qin2, Zhanfei Li1
1Trauma Center/Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Frontiers in Immunology
|February 27, 2023
Summary
Early immune system changes in septic shock patients show increased neutrophils and cytokines, alongside decreased lymphocytes and immunoglobulins. Low IgM, C3, and lymphocyte counts independently predict mortality risk.
Area of Science:
- Immunology
- Critical Care Medicine
- Pathophysiology
Background:
- Septic shock is a life-threatening condition characterized by dysregulated immune responses.
- Understanding early immune alterations is crucial for predicting outcomes and developing targeted therapies.
Purpose of the Study:
- To investigate early changes in immune cell counts, function, and serum biomarkers in septic shock patients.
- To identify immune indicators associated with mortality in septic shock.
Main Methods:
- Comparative analysis of immune parameters in 243 septic shock patients (survivors vs. nonsurvivors) and 20 healthy controls.
- Univariate and multivariate logistic regression to identify independent mortality risk factors.
- Assessment of neutrophil counts, infection biomarkers, cytokines, lymphocyte subsets, immunoglobulins, and complement proteins.
Main Results:
- Septic shock patients exhibited elevated neutrophils, infection biomarkers, and cytokines (IL-1β, IL-2R, IL-6, IL-8, IL-10, TNF-α).
- Significant decreases were observed in lymphocyte counts/subsets, immunoglobulin levels (IgA, IgG, IgM), and complement proteins (C3, C4).
- Nonsurvivors showed higher cytokines (IL-6, IL-8, IL-10) and lower IgM, C3, C4, lymphocyte, CD4+, and CD8+ T cell counts compared to survivors.
Conclusions:
- Low IgM, C3 concentrations, and low lymphocyte or CD4+ T cell counts are independent risk factors for mortality in septic shock.
- Early immune dysregulation, including lymphocytopenia and hypocomplementemia, significantly impacts septic shock outcomes.
- These findings highlight potential targets for novel immunotherapies in septic shock management.
