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Early alterations of B cells in patients with septic shock

Jorge Monserrat, Raul de Pablo, David Diaz-Martín

    Critical Care (London, England)
    |June 1, 2013
    PubMed

    Insights

    B lymphocytes play a role in septic shock. Abnormalities in B cell subsets, specifically low CD23+ and high CD80+/CD95+ expression, at ICU admission predict mortality in septic shock patients.

    Area of Science:

    • Immunology
    • Critical Care Medicine
    • Hematology

    Background:

    • Emerging evidence suggests B lymphocytes contribute to sepsis pathogenesis.
    • Investigating B cell subset distribution and activation in septic shock is crucial.

    Purpose of the Study:

    • To investigate potential abnormalities in circulating B lymphocyte subsets and activation in patients with septic shock.
    • To identify B cell markers associated with mortality in septic shock.

    Main Methods:

    • Observational prospective study in a medical-surgical ICU.
    • Quantitative flow cytometry assessed B-cell phenotypes (CD19+, CD19+CD69+, CD19+CD23+, CD19+CD5+, CD19+CD80+, CD19+CD86+, CD19+CD40+, CD19+CD95+) in 52 septic shock patients and 36 healthy controls.
    • B-cell assessments were performed at ICU admission and at 3, 7, 14, and 28 days post-admission.

    Main Results:

    • Septic shock patients exhibited persistent lymphopenia throughout the 28-day follow-up.
    • Nonsurvivors showed a lower percentage of CD19+CD23+ B cells and higher CD80+ and CD95+ expression compared to survivors within the first 7 days.
    • Receiver operating characteristic analysis indicated that a CD19+CD23+ level below 64.6% at ICU admission predicted non-survival with 90.9% sensitivity and 80.0% specificity.

    Conclusions:

    • Distinct patterns of circulating B lymphocyte abnormalities differentiate septic shock survivors from non-survivors.
    • Low CD23+ and high CD80+/CD95+ expression on B cells at ICU admission are associated with increased mortality in septic shock.
    • A sustained decrease in circulating B cells was observed during the 28-day ICU follow-up.
    Abstract

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