Role Of T Lymphocytes Apoptosis In Immunosuppression/Immunoparalysis And Prognosis Of Sepsis

Objective: To investigate changes of T lymphocyte subsets and T lymphocytes apoptosis in sepsis and its relationship with prognosis.Methods: sepsis patients from Intensive Care Unit of The First Affiliated Hospital of Chongqing Medical University from October 1, 2014 to December 31, 2015, were enrolled. The APACHEⅡscore and,SOFA score were calculated and the risk of death(R)was predicated according to APACHEⅡscore, and the survival rate of 28 days were followed up. We measured absolute count of peripheral blood T-lymphocyte subsets by flow cytometry, T-lymphocyte apoptosis by flow cytometry and TUNEL assay.We cultured immortalized line of human T lymphocyte cells(Jurkat) and treated cells with serum from sepsis patients or healthy control subjects,then measured apoptosis by flow cytometry and TUNEL assay,Cleaved-caspase 3, Bcl-2 and Mcl-1 expression by Western blot analysis.Results: We found decreased peripheral blood CD3~+ cell count,CD3~+CD4~+ cell count, CD3~+CD8~+ cell count and CD4~+/CD8~+ ratio,which exhibited a negative relationship with APACHE score,SOFAscore,and predicted risk of death score(R), increased CD3~+T-lymphocyte apoptosis and up-regulated Cleaved-caspase3 expression in sepsis patients,particularly in the death subgroup; increased cell apoptosis, down-regulated Mcl-1 and Bcl-2 in Jurkat cell induced by serum from sepsis patients,particularly serum from death subgroup of sepsis patients.Conclusion:Declined T-lymphocyte cell count and increased T lymphocyte apoptosis in sepsis are related to the severity of illness and prognosis.