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  • Poster presentation
  • Open Access

Decreased peripheral CD4+/CD8+ lymphocytes and poor prognosis in aged sepsis

  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care201216 (Suppl 1) :P5

https://doi.org/10.1186/cc10612

  • Published:

Keywords

  • Poor Prognosis
  • Peripheral Blood Mononuclear Cell
  • Septic Patient
  • Adult Group
  • Cytokine Concentration

Introduction

Aging is a significant factor and is associated with a poor prognosis in sepsis; however, the mechanism of immunological changes in aged sepsis is still unclear. The purpose of this study was to clarify the immunological changes in sepsis of aged patients.

Methods

Forty-four septic patients and 48 gender-matched healthy volunteers were prospectively enrolled in the study, which included the following investigations: (1) The SOFA score and clinical outcome were compared between adult sepsis (<65 years of age) and older adult sepsis (≥65 years of age). (2) Blood samples were collected from septic and control volunteers. Separated peripheral blood mononuclear cells were stained with CD4, CD8, programmed death-1 (PD-1), CD28, and CD62L antibodies and analyzed by flow cytometry, and serum was used to measure cytokine concentrations by using multiplex bead assay. Values were compared among four groups: normal adult (<65 years of age), normal older adult (≥65 years of age), adult sepsis (<65 years of age), and older adult sepsis (≥65 years of age) groups.

Results

(1) No differences in SOFA scores were observed between adult sepsis (n = 19, 39 years) and older adult sepsis (n = 25, 78 years), but 3-month survival in older adult sepsis was significantly decreased compared with that in adult sepsis (36% vs. 4%, P < 0.05). (2) Population of CD8+ T cells in normal older adults was significantly less than that in normal adults (1.5 × 105 vs. 5.7 × 104/ml, P < 0.01), and percentage of PD-1+CD8+ T cells in the older adult sepsis group was significantly greater than that in the normal older adult group (40% vs. 29%, P < 0.01). Population of CD4+, CD62L+CD4+, and CD28+CD4+ T cells in the older adult sepsis group was significantly less than that in the normal older adult group (n = 26, 80 years) (1.8 × 105 vs. 5.9 × 104/ml, 1.6 × 105 vs. 5.4 × 104/ml, and 1.6 × 105 vs. 4.4 × 104/ml, respectively; P < 0.01); however, these values did not differ between the adult sepsis and normal adult (n = 22, 39 years) groups. Serum IL-12 level in older adult sepsis was increased when compared with that in the other three groups (P < 0.01).

Conclusion

Poor prognosis in older adult sepsis may be related to both preexisting decrease of CD8+ T cells with aging and loss of CD4+ T cells with sepsis.

Authors’ Affiliations

(1)
Tokai University, Kanagawa, Japan

Copyright

© Inoue et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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