Nedel Wagner, Henrique Lílian R, Portela Luis Valmor
Department of Intensive Care Unit, Conceição Hospital Group, Porto Alegre 91350200, Brazil.
Department of Biochemistry, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil.
World J Crit Care Med. 2025 Jun 9;14(2):98791. doi: 10.5492/wjccm.v14.i2.98791.
The global incidence of critical illness has been steadily increasing, resulting in higher mortality rates thereby presenting substantial challenges for clinical management. Among these conditions, sepsis stands out as the leading cause of critical illness, underscoring the urgent need for continued research to enhance patient care and deepen our understanding of its complex pathophysiology. Lymphocytes play a pivotal role in both innate and adaptive immune responses, acting as key regulators of the balance between pro-inflammatory and anti-inflammatory processes to preserve immune homeostasis. In the context of sepsis, an impaired immunity has been associated with disrupted lymphocytic metabolic activity, persistent pro-inflammatory state, and subsequent immunosuppression. These disruptions not only impair pathogen clearance but also predispose patients to secondary infections and hinder recovery, highlighting the importance of targeting lymphocyte dysfunction in sepsis management. Moreover, studies have identified absolute lymphocyte counts and derived parameters as promising clinical biomarkers for prognostic assessment and therapeutic decision-making. In particular, neutrophil-to-lymphocyte ratio, and lymphopenia have gained recognition in the literature as a critical prognostic markers and therapeutic target in the management of sepsis. This review aims to elucidate the multifaceted role of lymphocytes in pathophysiology, with a focus on recent advancements in their use as biomarkers and key findings in this evolving field.
危重病的全球发病率一直在稳步上升，导致死亡率升高，从而给临床管理带来巨大挑战。在这些病症中，脓毒症是危重病的主要原因，这突出表明迫切需要持续开展研究，以改善患者护理并加深我们对其复杂病理生理学的理解。淋巴细胞在先天性和适应性免疫反应中都起着关键作用，是促炎和抗炎过程之间平衡的关键调节因子，以维持免疫稳态。在脓毒症的背景下，免疫功能受损与淋巴细胞代谢活动紊乱、持续的促炎状态以及随后的免疫抑制有关。这些紊乱不仅损害病原体清除，还使患者易发生继发性感染并阻碍康复，凸显了在脓毒症管理中针对淋巴细胞功能障碍的重要性。此外，研究已将绝对淋巴细胞计数和衍生参数确定为用于预后评估和治疗决策的有前景的临床生物标志物。特别是，中性粒细胞与淋巴细胞比率和淋巴细胞减少在文献中已被公认为脓毒症管理中的关键预后标志物和治疗靶点。本综述旨在阐明淋巴细胞在病理生理学中的多方面作用，重点关注其作为生物标志物的最新进展以及这一不断发展领域的关键发现。
