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High-Dimensional Flow Cytometry Identifies Immune Signatures Associated with Septic Shock Severity in Critically Ill
Miguel Bardají-Carrillo1, Rosa Dolores Prieto-Utrera2, Rosa Cobo-Zubia2
1BioCritic, Group for Biomedical Research in Critical Care Medicine, 47003, Valladolid, Spain; Anesthesiology and Critical Care, Clinical University Hospital of Valladolid, Av. Ramón y Cajal, 3, 47003, Valladolid, Spain; Department of Surgery, University of Valladolid, 47003, Valladolid, Spain; Health Research Institute of Valladolid (IBioVALL), Valladolid, Spain; Biomedical Research Networking Center in Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain.
Septic shock significantly reduces dendritic and NK-like immune cells. Combining immune cell analysis with clinical markers improves sepsis severity prediction, aiding early risk stratification.
Area of Science:
- Immunology
- Critical Care Medicine
- Biomarker Discovery
Background:
- Sepsis and septic shock cause severe immune dysregulation and high mortality.
- Current biomarkers lack accuracy for early risk stratification.
- Immune cell alterations are key to understanding disease severity.
Purpose of the Study:
- Characterize immune cell alterations in postoperative ICU patients using spectral flow cytometry.
- Investigate the association between immune cell changes and disease severity.
- Combine immune profiling with clinical biomarkers for improved risk stratification.
Main Methods:
- Prospective multicentre study of 219 postoperative ICU patients (non-septic, sepsis, septic shock).
- Spectral flow cytometry analysis of peripheral blood mononuclear cells (PBMCs).
- Logistic regression, ROC analysis, and single-cell RNA sequencing for validation.
Main Results:
- Septic shock patients showed reduced CD2-/CD8+ NK-like cells and dendritic cells.
- Lactate, neutrophil-to-lymphocyte ratio, dendritic cells, and NK-like cells were associated with septic shock.
- Combined model (AUC=0.870) demonstrated superior performance in discriminating disease severity.
Conclusions:
- Septic shock exhibits a distinct immune signature with reduced dendritic and NK-like cells.
- Integrating immune profiling with routine biomarkers enhances disease severity discrimination.
- Immune phenotyping shows promise for sepsis management and further research.
