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Critical Care

Volume 18 Supplement 2

Sepsis 2014

Open Access

High frequency of myeloid-derived suppressor cells in sepsis patients, with the granulocytic subtype dominating in Gram-positive cases

  • H Janols1, 2,
  • C Bergenfelz2,
  • R Allaoui2,
  • A-M Larsson3,
  • L Rydén4,
  • S Björnsson5,
  • S Janciauskiene6,
  • M Wullt1,
  • A Bredberg7 and
  • K Leandersson2
Critical Care201418(Suppl 2):P3

Published: 3 December 2014


Chronic InflammationDensity GradientCytokine LevelMyeloid CellHeterogeneous Population


Myeloid-derived suppressor cells (MDSCs) constitute a heterogeneous population of immature myeloid cells that potently suppress immune responses. They were originally identified in cancer patients and have since been reported to occur also in chronic inflammation, autoimmunity and even bacterial infections. Human MDSCs are commonly divided into monocytic (Mo-MDSCs) and granulocytic (PMN-MDSCs) subtypes. To what extent the bona fide cancer MDSCs are representative of the proposed MDSCs found in other diseases is not well known. PMN-MDSCs have previously been found to be enriched among low-density granulocytes (LDGs) in density gradient centrifuged blood.


In this study we analyzed potential MDSCs in sepsis patients with different causative microorganisms, using total peripheral blood as compared to density gradient centrifuged blood.


We found a high frequency of typical CD14+HLADRlow Mo-MDSCs in all sepsis patients, whereas the typical PMN-MDSCs as well as a prominent CD14low PMN-MDSC-like population appeared preferentially in Gram-positive cases (Figures 1 to 3). The CD14low PMN-MDSC variant was demonstrated to suppress T-cell proliferation in vitro via a ROS-dependent mechanism, to display an increased IL-10:TNFα ratio, and to present with signs of immaturity: blast morphology and low cytokine levels (Figures 4 and 5).

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5


We conclude that a spectrum of cells with MDSC features are enriched in sepsis, and that microbial origin of sepsis contributes to the substantial interindividual patient variation in MDSC pattern.

Authors’ Affiliations

Department of Infectious Diseases, Skane University Hospital, Lund University, Malmo, Sweden
Center for Molecular Pathology, Skane University Hospital, Lund University, Malmo, Sweden
Department of Laboratory Medicine, TCR, MV, Lund University, Lund, Sweden
Department of Surgery, Lund University Hospital, SUS, Lund, Sweden
Cytometry Laboratory and Department of Laboratory Medicine, Skane University Hospital, Lund University, Malmo, Sweden
Department of Pulmonology, Hannover Medical School, Hannover, Germany
Department of Medical Microbiology, Skane University Hospital, Lund University, Malmo, Sweden


© Janols et al.; licensee BioMed Central Ltd. 2014

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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.