90th Annual Meeting Abstracts
CD29 expression on T-Lymphocytes is suppressed in Septic Patients compared with patients exhibiting Systemic Inflammatory Response Syndrome (SIRS)
*Daithi S Heffernan, MD AFRCSI1, *Gwendolyn F Elphick, PhD2, *Mai Tran, BS2, William G Cioffi, MD1, *Alfred Ayala, PhD2
1Division of Surgical Research, Brown University, Rhode Island Hospital, Providence, RI;2Division of Surgical Research, Rhode Island Hospital, Providence, RI
Objective: Sepsis is associated with T-lymphocyte loss, dysfunction and anergy. In counterdistinction, early Systemic Inflammatory Response Syndrome (SIRS) is a hyper-inflammatory response. T-cells strongly rely on their ability to traffic between organs via the blood. Integrins are critically important in this trafficking to extravascular tissues. Integrin beta1 (CD29) also alters lymphocytic apoptosis. We hypothesized that T-cell migratory ability will be suppressed as denoted by altered integrin expression.
Design: A cohort study of ICU patients with sepsis versus systemic inflammatory response syndrome (SIRS) compared with normal healthy controls.
Setting: University/Level 1 Adult Trauma and Surgical Intensive Care Units
Patients: 14 septic patients, 11 patients with SIRS and 4 healthy volunteers.
Interventions: Blood was collected from patients at the time of daily lab draws in the ICU. Daily white cell count was recorded. Flow cytometry was used to detect monoclonal antibodies to CD3. Cells were double stained for either CD3/CD29 (Integrin beta1) or CD3/CD18 (integrin beta2).
Main Outcome measures: The percentage and absolute number of circulating CD3+ lymphocytes expressing CD29, CD3+ Lymphocytes expressing CD18.
Results: There was no difference in the CD3+/CD18+ expression between patients who were septic (99.8%), SIRS (99.85%) healthy controls (99.9%). There was a significant decrease in CD3/CD29 expression in Septic Vs SIRS patients (49.9% vs 84.125%; p=0.001) and Septic vs healthy controls (49.9% vs 79.5%; p=0.001). Patients who sustained trauma/SIRS who subsequently progressed to sepsis (n=4) mimicked this pattern with initial mean CD3/CD29 expression of 81%, falling to 54% in sepsis.
Conclusions: Septic patients display immunosuppression and lymphocytic dysfunction. This data supports functional migratory ability loss of T-cells in septic patients as noted by loss of CD29 (Integrin beta1) expression.