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Critical Care

, 17:R105

First Online: 30 May 2013Received: 11 December 2012Revised: 19 May 2013Accepted: 30 May 2013

Abstract

IntroductionIt has recently been proposed that B lymphocytes are involved in sepsis pathogenesis. The goal of this study is to investigate potential abnormalities in a subset distribution and activation of circulating B lymphocytes in patients with septic shock.

MethodsThis observational prospective study was conducted in a medical-surgical ICU. All patients with septic shock were eligible for inclusion. B-cell phenotypes CD19+CD69+, CD19+CD23+, CD19+CD5+, CD19+CD80, CD19+CD86+, CD19+CD40 and CD19+CD95+ were assessed by quantitative flow cytometry upon admission to the ICU and 3, 7, 14 and 28 d later.

ResultsFifty-two patients were included. Thirty-six healthy volunteers matched for age and sex were used as controls. The patients had lymphopenia that was maintained during 28 d of follow-up. In patients with septic shock who died, the percentage of CD19+CD23+ was lower during the 7 d of follow-up than it was in survival patients. Moreover, the percentage of CD80+ and CD95+ expression on B cells was higher in patients who died than in survivors. Receiver operating characteristic curve analysis showed that a CD19+CD23+ value of 64.6% at ICU admission enabled discrimination between survivors and nonsurvivors with a sensitivity of 90.9% and a specificity of 80.0% P = 0.0001.

ConclusionsPatients with septic shock who survive and those who don-t have different patterns of abnormalities in circulating B lymphocytes. At ICU admission, a low percentage of CD23+ and a high of CD80+ and CD95+ on B cells were associated with increased mortality of patients with septic shock. Moreover, a drop in circulating B cells persisted during 28 d of ICU follow-up.

KeywordsApoptosis B cells Flow cytometry Lymphocyte Lymphocyte activation Phenotype Sepsis Septic shock AbbreviationsAIDSacquired immunodeficiency syndrome

APACHE IIAcute Physiology and Chronic Health Evaluation II

CDcluster of differentiation

CIconfidence interval

FITCfluorescein isothiocyanate

ICUintensive care unit

IL-10interleukin 10

IRA-B cellsinnate response activator B cells

mAbmonoclonal antibodies

PBMCperipheral blood mononuclear cell

PEphycoerythrin

ROCreceiver-operating characteristic

SEMstandard error of the mean

TCphycoerythrin-cyanine 5 tricolor.

Electronic supplementary materialThe online version of this article doi:10.1186-cc12750 contains supplementary material, which is available to authorized users.

Jorge Monserrat, Raul de Pablo contributed equally to this work.

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Autor: Jorge Monserrat - Raul de Pablo - David Diaz-Martín - Manuel Rodríguez-Zapata - Antonio de la Hera - Alfredo Prieto - Melc

Fuente: https://link.springer.com/



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