PURPOSE: Sepsis is associated with alterations in host immune function. Currently, those suffering from sepsis are classified according to a clinical phenotype with little or no knowledge of their immune status. We hypothesize that measured immune function will correlate with clinical outcomes.
METHODS: A biomarker that detects cell mediated immunity (CMI) by measuring the concentration of adenosine triphosphate (ATP) released from CD4+ T cells following mitogen stimulation was prospectively evaluated in 30 patients admitted with sepsis to an ICU.
RESULTS: Patients with sepsis (n=30) have significantly higher mean amounts of ATP in their nonstimulated CD4+ T cells compared to healthy controls (n=35), 32 ng/mL and 12 ng/mL, respectively (p<0.05). Patients with sepsis have significantly lower mean amounts of ATP in their stimulated CD4+ T cells than healthy controls, 377 ng/mL and 471 ng/mL, respectively (p<0.05). Survivors of sepsis (n=22) have significantly higher mean amounts of ATP in their stimulated CD4+ T cells than nonsurvivors of sepsis (n=8), 433 ng/mL and 223 ng/mL, respectively (p<0.05).
CONCLUSION: Low levels of cell mediated immune function are associated with mortality in patients with sepsis.
CLINICAL IMPLICATIONS: Recognition of an immunological phenotype in patients with sepsis may provide improved early risk stratification.
DISCLOSURE: Kevin Lawrence, Other This study was supported by Cylex Inc. which owns the patented Immuknow technology.; No Product/Research Disclosure Information