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Title: Early natural killer cell counts in blood predict mortality in severe sepsis
Authors: Andaluz-Ojeda, David
Iglesias, Verónica
Bobillo, Felipe
Almansa, Raquel
Rico, Lucía
Gandía, Francisco
Loma, Ana María
Nieto, Concepción
Diego, Rosa
Ramos, Epifanio
Nocito, Mercedes
Resino, Salvador
Eiros Bouza, José María
Tamayo Gómez, Eduardo
Ortiz de Lejarazu y Leonardo, Raúl
Bermejo-Martin, Jesús F.
Issue Date: 2011
Publisher: BioMed Central
Description: Producción Científica
Citation: Critical Care, 2011, 15(5):R243
Abstract: In an attempt to evaluate the quantitative changes in the status of immunocompetence in severe sepsis over time and its potential influence on clinical outcome, we monitored the evolution of immunoglobulins (Igs) (IgG, IgA and IgM), complement factors (C3 and C4) and lymphocyte subsets (CD4+ T cells, CD8+ T cells, B cells (CD19+) and natural killer (NK) cells (CD3-CD16+CD56+)) in the blood of 50 patients with severe sepsis or septic shock at day 1, day 3 and day 10 following admission to the ICU. Twenty-one patients died, ten of whom died within the 72 hours following admission to the ICU. The most frequent cause of death (n = 12) was multiorgan dysfunction syndrome. At day 1, survivors showed significantly higher levels of IgG and C4 than those who ultimately died. On the contrary, NK cell levels were significantly higher in the patients who died. Survivors exhibited a progressive increase from day 1 to day 10 on most of the immunological parameters evaluated (IgG, IgA, IgM, C3, CD4+, CD8+ T cells and NK cells). Multivariate Cox regression analysis, including age, sex, APACHE II score, severe sepsis or septic shock status and each one of the immunological parameters showed that NK cell counts at day 1 were independently associated with increased risk of death at 28 days (hazard ratio = 3.34, 95% CI = 1.29 to 8.64; P = 0.013). Analysis of survival curves provided evidence that levels of NK cells at day 1 (> 83 cells/mm3) were associated with early mortality. Our results demonstrate the prognostic role of NK cells in severe sepsis and provide evidence for a direct association of early counts of these cells in blood with mortality.
Keywords: Septicemia - Mortalidad
ISSN: 1364-8535
Peer Review: SI
DOI: 10.1186/cc10501
Language: eng
Rights: info:eu-repo/semantics/openAccess
Appears in Collections:DEP03 - Artículos de revista

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