Coman Oana, Grigorescu Bianca-Liana, Huțanu Adina, Bacârea Anca, Văsieșiu Anca Meda, Fodor Raluca Ștefania, Petrișor Marius, Azamfirei Leonard
Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology "George Emil Palade", 540142 Targu Mures, Romania.
Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology "George Emil Palade", 540142 Targu Mures, Romania.
Int J Mol Sci. 2024 Nov 24;25(23):12612. doi: 10.3390/ijms252312612.
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 ( < 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.
脓毒症的病理生理学涉及对感染的免疫反应失调、过度炎症反应和免疫麻痹。本研究探讨细胞死亡生物标志物（程序性细胞死亡蛋白1（PD-1）、程序性死亡配体1（PD-L1）和白细胞介素-7（IL-7）的血清可溶性水平）与脓毒症严重程度和进展相关的各种淋巴细胞亚群百分比之间的关系。这项前瞻性观察性研究纳入了87例危重症患者。我们在第1天（根据脓毒症-3共识诊断脓毒症）和第5天监测各项参数。通过比较健康对照组和脓毒症患者之间的水平（<0.0001），我们确定IL-7的临界值为1.94 pg/mL。所有患者均观察到淋巴细胞减少，辅助性T淋巴细胞与细胞毒性淋巴细胞和B淋巴细胞之间呈负相关，所有组中细胞毒性淋巴细胞之间呈正相关。我们发现PD-1/PD-L1与淋巴细胞亚群之间存在相关性。在非存活者中，IL-7与PD-1呈统计学相关性。评估淋巴细胞水平显示出作为评估脓毒症进展生物标志物的潜力。监测IL-7水平有助于评估生存情况，因为低水平与更高的死亡风险相关。监测IL-7水平有助于评估生存情况，因为低水平与更高的死亡风险相关。PD-1/PD-L1表达升高会损害共刺激信号传导，降低T细胞反应并导致淋巴细胞减少，从而增加医院感染的风险。
