Hu Zihan, Dong Danjiang, Peng Fei, Zhou Xing, Sun Qin, Chen Hui, Chang Wei, Gu Qin, Xie Jianfeng, Yang Yi
Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China.
Department of Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China.
J Inflamm Res. 2023 Oct 18;16:4725-4732. doi: 10.2147/JIR.S426828. eCollection 2023.
Immune dysfunction plays a pivotal role in sepsis pathogenesis. Previous studies have revealed the crucial role of T cells and human leukocyte antigen-DR (HLA-DR) in sepsis. However, the function of natural killer (NK) cells remains unclear. This study aimed to investigate whether NK cells are associated with sepsis prognosis. In addition, we aimed to explore the interrelation and influence between NK and other immunological features in patients with sepsis.
This retrospective, observational study included patients with sepsis from two hospitals in mainland China. The clinical characteristics and immune results during the early phase were collected. Patients were classified according to the level of immune cells to analyze the relationship between immunological features and 28-day mortality.
A total of 984 patients were included in this study. Non-survivors were older and had lower levels of lymphocytes, monocytes, NK cells, HLA-DR, and T cells. Patients were classified into eight groups according to their levels of NK cells, HLA-DR, and T cells. Only patients with decreased NK and T cell counts showed a significant increase in 28-day mortality. An increase in CD8+ T cells was correlated with the alleviation of 28-day mortality only among patients with high NK cell levels.
This study provides novel insights into the association between NK cells and 28-day mortality as well as the interrelation between NK cells and other immune cells in sepsis. The relationship between CD8+ T cells and 28-day mortality in sepsis is dependent on NK cell count.
免疫功能障碍在脓毒症发病机制中起关键作用。既往研究揭示了T细胞和人类白细胞抗原-DR（HLA-DR）在脓毒症中的关键作用。然而，自然杀伤（NK）细胞的功能仍不明确。本研究旨在探讨NK细胞是否与脓毒症预后相关。此外，我们旨在探究脓毒症患者中NK细胞与其他免疫特征之间的相互关系及影响。
这项回顾性观察性研究纳入了来自中国大陆两家医院的脓毒症患者。收集了早期阶段的临床特征和免疫结果。根据免疫细胞水平对患者进行分类，以分析免疫特征与28天死亡率之间的关系。
本研究共纳入984例患者。未存活者年龄较大，淋巴细胞、单核细胞、NK细胞、HLA-DR和T细胞水平较低。根据NK细胞、HLA-DR和T细胞水平将患者分为八组。仅NK细胞和T细胞计数降低的患者28天死亡率显著升高。仅在NK细胞水平较高的患者中，CD8+T细胞增加与28天死亡率降低相关。
本研究为NK细胞与28天死亡率之间的关联以及脓毒症中NK细胞与其他免疫细胞之间的相互关系提供了新的见解。脓毒症中CD8+T细胞与28天死亡率之间的关系取决于NK细胞计数。
