Increased circulating regulatory T cells (CD4(+)CD25 (+)CD127 (-)) contribute to lymphocyte anergy in septic shock patients

• Published in: Intensive care medicine Vol. 35; no. 4; pp. 678 - 686
• Main Authors: Venet, Fabienne, Chung, Chun-Shiang, Kherouf, Hakim, Geeraert, Anne, Malcus, Chistophe, Poitevin, Françoise, Bohé, Julien, Lepape, Alain, Ayala, Alfred, Monneret, Guillaume
• Format: Journal Article
• Language: English
• Published: United States 01-04-2009
• Subjects: Aged; Aged, 80 and over; Antigens, Differentiation, T-Lymphocyte - immunology; Apoptosis - physiology; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - immunology; Cell Proliferation; Energy Metabolism - physiology; Female; Flow Cytometry; Humans; Interleukin-2 Receptor alpha Subunit - immunology; Interleukin-7 Receptor alpha Subunit - immunology; Male; Middle Aged; Shock, Septic - immunology; T-Lymphocytes, Regulatory - immunology
• ISSN: 1432-1238
• DOI: 10.1007/s00134-008-1337-8

Sepsis syndrome represents the leading cause of death in intensive care unit. Patients present features consistent with a decline in immune responsiveness potentially contributing to mortality. We investigated whether CD4(+)CD25(+) regulatory T cells (Treg) participate in the induction of lymphocyte anergy after sepsis.
Observational study in septic shock patients and experimental study in mice.
We took advantage of the recently described flow cytometric gating strategy using the measurement of CD25 and CD127 expressions for monitoring Treg (CD4(+)CD25(+)CD127(-)Foxp3(+)). In patients the increased circulating Treg percentage significantly correlated with a decreased lympho-proliferative response. In a murine model of sepsis mimicking these observations, the ex vivo downregulation of Foxp3 expression using siRNA was associated with a restoration of this response.
The relative increase in circulating Treg might play a role in lymphocyte anergy described after septic shock and represent a standardizable surrogate marker of declining proliferative capacity after sepsis.