Investigating the expression of lymphocyte surface markers and serum cytokine levels in patients with sepsis in intensive care units

INVESTIGATING THE EXPRESSION OF LYMPHOCYTE SURFACE MARKERS AND SERUM CYTOKINE LEVELS IN PATIENTS WITH SEPSIS IN INTENSIVE CARE UNITSSepsis is defined as the clinical condition characterized by the presence of both infection and the systemic inflammatory response syndrome together. In recent years, with greater life expectancy and age related defects in the human immune system, increased incidence of HIV infections and wider use of immunosuppressive therapeutic modalities give rise in the rate of sepsis.A better understanding of the pathophysiology of the sepsis is critically important in the context of developing new, future strategies for the diagnosis and treatment of sepsis. For this reason, aim of our study was to investigate immunological changes that are effective factors in the pathogenesis of sepsis.Lymphocyte cell surface markers were determined in 26 patients with the diagnosis of sepsis by flow cytometry and alterations in lymphocyte sub-populations were searched during the course of sepsis. Additionally serum cytokine levels were measured by ELISA method in all groups.Our results indicate a statistically significant decreased rates of total CD4+, CD8+ and CD3+ T lymphocytes in patients with gram positive and gram negative sepsis groups compared with healthy control group.(p<0.001)There was no statistically significant difference between the patient groups with sepsis and healthy controls in terms of NK cell levels.CD19, the surface marker of B lymphocyte, levels showed an increase in patient groups with sepsis; whereas CD14+ monocyte rates were lower in both sepsis groups compared with healthy control group. CD4+ CD25+ T lymphocyte rates were found to be increased in sepsis patients.CD69 levels, which are activation marker of CD4+ and CD8+ T cells, were found to be increased in both sepsis groups.TLR-2 expression was increased in gram positive sepsis group. TLR-4 was increased in both gram positive and negative sepsis groups but its level was greater in gram negative sepsis group.TNF ?, IFN ?, IL-1ß, IL-6 and IL-10 levels were determined higher in both sepsis groups when compared with the control group. There was no statistically significant difference in IL-2 levels between sepsis groups and healthy control group.As a result, there is a significant suppression especially at the levels of peripheral blood T lymphocytes and monocytes during the course of sepsis; and it is determined that there happens changes in both Th1 and Th2 cytokine profiles. This situation considers immunologic changes that happen during the course of sepsis may play an effective role in the pathogenesis of sepsis.