Células Reguladoras, T CD4+CD25+ e Células NKT na Sepse Grave e Choque Séptico. / The regulatory T cell, CD4+CD25+ and NKT cells in Severe Sepsis and Septic Shock

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Sepsis, septic shock and multiple organ failure remain the leading cause of death in the intensive care unit despite significant advances in patient care. However, the mechanisms responsible for this high mortality remain not totally clear, considering that these patients have a generalized immune dysfunction and immunosuppression status. Actually, recent studies have suggested that several lymphocyte subpopulations, among them, the regulatory T CD4+CD25+Foxp3+ and NKT cells, were demonstrated to have an important role in peripheral tolerance. Aim: To determine the frequency the regulatory T CD4+CD25+Foxp3+ and NKT cells, in patients with septic shock and severe sepsis, and evaluate with the clinical correlation ship. Methods: A total of 23 patients were prospectively enrolled: 16 with septic shock and 7 with severe sepsis. Sepsis was diagnosed based on the criteria of the American College of Chest Physicians/ Society of Critical Care Medicine (Bone, 1992). We analysed samples using a quantitative polymerase chain reaction assay to measure the levels of messenger RNA (mRNA) of Foxp3, CTLA-4 and GITR, all related to Tregs phenotype/function, and Vα24JA18 to NKT cells presence in blood samples of the patients with severe sepsis and septic shock in intensive care units. As controls, we used blood samples of 12 healthy subjects. Across of the FACS we studied the frequency the regulatory T CD4+CD25+Foxp3+ and NKT cells in blood samples. Results: our data showed a decreased level of mRNA of Foxp3, CTLA-4 and GITR in groups severe sepsis and septic shock patients as compared to health volunteers (p=0.0184, p=0.008 and p=0.011, respectively). In the analyses of the presence of NKT cells, we observed that patients with sepsis displayed a decreased level of mRNA of the specific molecular marker compared to health volunteers. However, the patients what showed more frequency the NKT cells in periphery had the better survival.

ASSUNTO(S)

sepse choque septico celulas matadoras naturais linfocitos t cd4-positivos. nefrologia

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