| Autor: |
Coman O; Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Grigorescu BL; Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Huțanu A; Department of Laboratory Medicine, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania.; Centre for Advanced Medical and Pharmaceutical Research, Immunology, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Bacârea A; Department of Pathophysiology, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Văsieșiu AM; Department of Infectious Disease, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Fodor RȘ; Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Petrișor M; Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania., Azamfirei L; Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology 'George Emil Palade', 540142 Targu Mures, Romania. |
| Abstrakt: |
Sepsis pathophysiology involves a dysregulated immune response to infection, excessive inflammation, and immune paralysis. This study explores the relationships between cell death biomarkers (serum-soluble levels of programmed cell death protein 1 (PD-1), programmed death ligand 1 (PD-L1), and interleukin-7 (IL-7)) and the percentages of various lymphocyte subsets in relation to the severity and progression of sepsis. This prospective, observational study included 87 critically ill patients. We monitored parameters on days 1 (sepsis was diagnosed according to the Sepsis-3 Consensus) and 5. We established an IL-7 cutoff value of 1.94 pg/mL by comparing levels between a healthy control group and patients with sepsis ( p < 0.0001). Lymphopenia was observed in all patients, with negative correlations between helper T lymphocytes and cytotoxic and B lymphocytes, and positive correlations involving cytotoxic lymphocytes across all groups. We found correlations between PD-1/PD-L1 and lymphocyte subsets. IL-7 showed a statistical correlation with PD-1 in non-survivors. Assessing lymphocyte levels shows potential as a biomarker for evaluating the progression of sepsis. Monitoring IL-7 levels could help assess survival, as low levels are associated with higher mortality risk. Monitoring IL-7 levels could help assess survival, as low levels are associated with higher mortality risk. Elevated PD-1/PD-L1 expression impairs costimulatory signalling, reducing T cell responses and lymphopenia, which increases the risk of nosocomial infections. |
