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Low B and T lymphocyte attenuator expression on CD4(+) T cells in the early stage of sepsis is associated with the severity and mortality of septic patients: a prospective cohort study.

Shao R, Li CS, Fang Y, Zhao L, Hang C - Crit Care (2015)

Bottom Line: Our results showed that the percentage of BTLA(+)/CD4(+) T cells was high expression in healthy volunteers and it was statistically reduced in severe sepsis and septic shock compared with healthy controls(all P<0.01).The percentage of BTLA(+)/CD4(+)T cells was lower in non-survivors than in survivors (P<0.01), and similar results were obtained when expressed as mean of fluorescence intensities (MFI) (P<0.01).Adjusted logistic regression analysis suggested that the percentage of BTLA(+)/CD4(+) T cells was associated with 28-day mortality in septic patients (odds ratio (OR) = 0.394).

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Beijing Chao-yang Hospital, Capitcal Medical University, 8# Worker's Stadium South Road, Chao-yang District, Beijing, 100020, China. shaorui1008@163.com.

ABSTRACT

Introduction: B and T lymphocyte attenuator (BTLA) is an inhibitory receptor, whose primary role in CD4(+) T cell is thought to inhibit cytokine production. We explore BTLA expression on CD4(+) T cells in healthy controls and septic patients, and assess the correlation of BTLA expression on CD4(+) T cells in the early stage of sepsis with the severity and mortality of septic patients in the emergency department (ED).

Methods: 336 consecutive patients were included in this study. BTLA expression on CD4(+) T cells was measured by flow cytometry within 24h of ED admission.

Results: Our results showed that the percentage of BTLA(+)/CD4(+) T cells was high expression in healthy volunteers and it was statistically reduced in severe sepsis and septic shock compared with healthy controls(all P<0.01). The area under the receiver operating characteristic (AUC) curves of BTLA expression on CD4(+) T cells was slightly lower than that of procalcitonin (PCT) and Mortality in Emergency Department Sepsis (MEDS) score. The percentage of BTLA(+)/CD4(+)T cells was lower in non-survivors than in survivors (P<0.01), and similar results were obtained when expressed as mean of fluorescence intensities (MFI) (P<0.01). Adjusted logistic regression analysis suggested that the percentage of BTLA(+)/CD4(+) T cells was associated with 28-day mortality in septic patients (odds ratio (OR) = 0.394).

Conclusion: Our study shows that the percentage of BTLA(+)/CD4(+) T cells was high in healthy volunteers. Furthermore, lower percentage of BTLA(+)/CD4(+) T cells during the early stage of sepsis is associated with the severity and the mortality of septic patients.

No MeSH data available.


Related in: MedlinePlus

The percentage of B and T lymphocyte attenuator (BTLA)+/CD4+ T cells in five groups. There was a stepwise reduction in the percentage of BTLA+/CD4+T cells from patients with systemic inflammatory response syndrome (SIRS) compared to patients with sepsis, severe sepsis, or septic shock
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Fig2: The percentage of B and T lymphocyte attenuator (BTLA)+/CD4+ T cells in five groups. There was a stepwise reduction in the percentage of BTLA+/CD4+T cells from patients with systemic inflammatory response syndrome (SIRS) compared to patients with sepsis, severe sepsis, or septic shock

Mentions: The median levels of BTLA expression on CD4+T cells in each group are presented in Table 1. The median value of the percentage of BTLA+/CD4+T cells in healthy volunteers was 90.2 % (85.5−91.9 %). Interestingly, we observed that the percentage of BTLA+/CD4+T cells was significantly reduced in patients with severe sepsis or septic shock compared with healthy controls (all P <0.01). This was also obviously reduced in patients with septic shock compared with patients with severe sepsis (P <0.05), However, there were no differences in the percentage of BTLA+/CD4+T cells between patients with SIRS and healthy volunteers or between patients with sepsis and healthy controls (P >0.05). There was a stepwise reduction in the percentage of BTLA+/CD4+T cells within 24 h of ED admission in patients with SIRS compared with patients with sepsis, severe sepsis, or septic shock (P <0.01; Figs. 1 and 2). We observed that the MFI of BTLA on CD4+ T cells was significantly higher in patients with SIRS or sepsis than in healthy controls (P <0.01), but there was no statistically significant difference between the MFI of BTLA on CD4+ T cells in patients with severe sepsis or septic shock and healthy controls (all P >0.05).Fig. 2


Low B and T lymphocyte attenuator expression on CD4(+) T cells in the early stage of sepsis is associated with the severity and mortality of septic patients: a prospective cohort study.

Shao R, Li CS, Fang Y, Zhao L, Hang C - Crit Care (2015)

The percentage of B and T lymphocyte attenuator (BTLA)+/CD4+ T cells in five groups. There was a stepwise reduction in the percentage of BTLA+/CD4+T cells from patients with systemic inflammatory response syndrome (SIRS) compared to patients with sepsis, severe sepsis, or septic shock
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4556404&req=5

Fig2: The percentage of B and T lymphocyte attenuator (BTLA)+/CD4+ T cells in five groups. There was a stepwise reduction in the percentage of BTLA+/CD4+T cells from patients with systemic inflammatory response syndrome (SIRS) compared to patients with sepsis, severe sepsis, or septic shock
Mentions: The median levels of BTLA expression on CD4+T cells in each group are presented in Table 1. The median value of the percentage of BTLA+/CD4+T cells in healthy volunteers was 90.2 % (85.5−91.9 %). Interestingly, we observed that the percentage of BTLA+/CD4+T cells was significantly reduced in patients with severe sepsis or septic shock compared with healthy controls (all P <0.01). This was also obviously reduced in patients with septic shock compared with patients with severe sepsis (P <0.05), However, there were no differences in the percentage of BTLA+/CD4+T cells between patients with SIRS and healthy volunteers or between patients with sepsis and healthy controls (P >0.05). There was a stepwise reduction in the percentage of BTLA+/CD4+T cells within 24 h of ED admission in patients with SIRS compared with patients with sepsis, severe sepsis, or septic shock (P <0.01; Figs. 1 and 2). We observed that the MFI of BTLA on CD4+ T cells was significantly higher in patients with SIRS or sepsis than in healthy controls (P <0.01), but there was no statistically significant difference between the MFI of BTLA on CD4+ T cells in patients with severe sepsis or septic shock and healthy controls (all P >0.05).Fig. 2

Bottom Line: Our results showed that the percentage of BTLA(+)/CD4(+) T cells was high expression in healthy volunteers and it was statistically reduced in severe sepsis and septic shock compared with healthy controls(all P<0.01).The percentage of BTLA(+)/CD4(+)T cells was lower in non-survivors than in survivors (P<0.01), and similar results were obtained when expressed as mean of fluorescence intensities (MFI) (P<0.01).Adjusted logistic regression analysis suggested that the percentage of BTLA(+)/CD4(+) T cells was associated with 28-day mortality in septic patients (odds ratio (OR) = 0.394).

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Beijing Chao-yang Hospital, Capitcal Medical University, 8# Worker's Stadium South Road, Chao-yang District, Beijing, 100020, China. shaorui1008@163.com.

ABSTRACT

Introduction: B and T lymphocyte attenuator (BTLA) is an inhibitory receptor, whose primary role in CD4(+) T cell is thought to inhibit cytokine production. We explore BTLA expression on CD4(+) T cells in healthy controls and septic patients, and assess the correlation of BTLA expression on CD4(+) T cells in the early stage of sepsis with the severity and mortality of septic patients in the emergency department (ED).

Methods: 336 consecutive patients were included in this study. BTLA expression on CD4(+) T cells was measured by flow cytometry within 24h of ED admission.

Results: Our results showed that the percentage of BTLA(+)/CD4(+) T cells was high expression in healthy volunteers and it was statistically reduced in severe sepsis and septic shock compared with healthy controls(all P<0.01). The area under the receiver operating characteristic (AUC) curves of BTLA expression on CD4(+) T cells was slightly lower than that of procalcitonin (PCT) and Mortality in Emergency Department Sepsis (MEDS) score. The percentage of BTLA(+)/CD4(+)T cells was lower in non-survivors than in survivors (P<0.01), and similar results were obtained when expressed as mean of fluorescence intensities (MFI) (P<0.01). Adjusted logistic regression analysis suggested that the percentage of BTLA(+)/CD4(+) T cells was associated with 28-day mortality in septic patients (odds ratio (OR) = 0.394).

Conclusion: Our study shows that the percentage of BTLA(+)/CD4(+) T cells was high in healthy volunteers. Furthermore, lower percentage of BTLA(+)/CD4(+) T cells during the early stage of sepsis is associated with the severity and the mortality of septic patients.

No MeSH data available.


Related in: MedlinePlus