David Grimaldi1,2,3,4,5, Lionel Le Bourhis6,7,8, Bertrand Sauneuf9, Agnès Dechartres10,11, Christophe Rousseau12,13,10, Fatah Ouaaz12,13,10, Maud Milder6,7,8, Delphine Louis6,7,8, Jean-Daniel Chiche9,12,13,10, Jean-Paul Mira9,12,13,10, Olivier Lantz6,7,8, Frédéric Pène14,15,16,17. 1. Réanimation médicale, Hôpital Cochin AP-HP, 27 rue du Faubourg Saint Jacques, 75014, Paris, France. dgrimaldi@ch-versailles.fr. 2. Institut Cochin INSERM U1016, Paris, France. dgrimaldi@ch-versailles.fr. 3. CNRS UMR8104, Paris, France. dgrimaldi@ch-versailles.fr. 4. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. dgrimaldi@ch-versailles.fr. 5. Réanimation médico-chirurgicale, Centre Hospitalier de Versailles, Le Chesnay, France. dgrimaldi@ch-versailles.fr. 6. Institut Curie, Biologie des Tumeurs, Paris, France. 7. INSERM U932, Paris, France. 8. Centre d'investigation clinique CICBT507, Institut Curie/Institut Gustave Roussy, Paris, France. 9. Réanimation médicale, Hôpital Cochin AP-HP, 27 rue du Faubourg Saint Jacques, 75014, Paris, France. 10. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. 11. Centre d'épidémiologie clinique, Hôpital Hotel-Dieu, AP-HP, Paris, France. 12. Institut Cochin INSERM U1016, Paris, France. 13. CNRS UMR8104, Paris, France. 14. Réanimation médicale, Hôpital Cochin AP-HP, 27 rue du Faubourg Saint Jacques, 75014, Paris, France. frederic.pene@cch.aphp.fr. 15. Institut Cochin INSERM U1016, Paris, France. frederic.pene@cch.aphp.fr. 16. CNRS UMR8104, Paris, France. frederic.pene@cch.aphp.fr. 17. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. frederic.pene@cch.aphp.fr.
Abstract
PURPOSE: In between innate and adaptive immunity, the recently identified innate-like mucosal-associated invariant T (MAIT) lymphocytes display specific reactivity to non-streptococcal bacteria. Whether they are involved in bacterial sepsis has not been investigated. We aimed to assess the number and the time course of circulating innate-like T lymphocytes (MAIT, NKT and γδ T cells) in critically ill septic and non-septic patients and to establish correlations with the further development of intensive care unit (ICU)-acquired infections. METHODS: We prospectively enrolled consecutive patients with severe sepsis and septic shock. Controls were critically ill patients with non-septic shock and age-matched healthy subjects. Circulating innate-like lymphocytes were enumerated using a flow cytometry assay at day 1, 4 and 7. RESULTS: One hundred and fifty six patients (113 severe bacterial infections, 36 non-infected patients and 7 patients with severe viral infections) and 26 healthy subjects were enrolled into the study. Patients with severe bacterial infections displayed an early decrease in MAIT cell count [median 1.3/mm(3); interquartile range (0.4-3.2)] as compared to control healthy subjects [31.1/mm(3) (12.1-45.2)], but also to non-infected critically ill patients [4.3/mm(3) (1.4-13.2)] (P < 0.0001 for all comparisons). In contrast NKT and γδ T cell counts did not differ between patients groups. The multivariate analysis identified non-streptococcal bacterial infection as an independent determinant of decrease in MAIT cell count. Furthermore, the incidence of ICU-acquired infections was higher in patients with persistent MAIT cell depletion. CONCLUSIONS: This large human study provides valuable information about MAIT cells in severe bacterial infections. The persistent depletion of MAIT cells is associated with the further development of ICU-acquired infections.
PURPOSE: In between innate and adaptive immunity, the recently identified innate-like mucosal-associated invariant T (MAIT) lymphocytes display specific reactivity to non-streptococcal bacteria. Whether they are involved in bacterial sepsis has not been investigated. We aimed to assess the number and the time course of circulating innate-like T lymphocytes (MAIT, NKT and γδ T cells) in critically ill septic and non-septic patients and to establish correlations with the further development of intensive care unit (ICU)-acquired infections. METHODS: We prospectively enrolled consecutive patients with severe sepsis and septic shock. Controls were critically ill patients with non-septic shock and age-matched healthy subjects. Circulating innate-like lymphocytes were enumerated using a flow cytometry assay at day 1, 4 and 7. RESULTS: One hundred and fifty six patients (113 severe bacterial infections, 36 non-infected patients and 7 patients with severe viral infections) and 26 healthy subjects were enrolled into the study. Patients with severe bacterial infections displayed an early decrease in MAIT cell count [median 1.3/mm(3); interquartile range (0.4-3.2)] as compared to control healthy subjects [31.1/mm(3) (12.1-45.2)], but also to non-infected critically ill patients [4.3/mm(3) (1.4-13.2)] (P < 0.0001 for all comparisons). In contrast NKT and γδ T cell counts did not differ between patients groups. The multivariate analysis identified non-streptococcal bacterial infection as an independent determinant of decrease in MAIT cell count. Furthermore, the incidence of ICU-acquired infections was higher in patients with persistent MAIT cell depletion. CONCLUSIONS: This large human study provides valuable information about MAIT cells in severe bacterial infections. The persistent depletion of MAIT cells is associated with the further development of ICU-acquired infections.
Authors: L A Mermel; B M Farr; R J Sherertz; I I Raad; N O'Grady; J S Harris; D E Craven Journal: Clin Infect Dis Date: 2001-04-03 Impact factor: 9.079
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Intensive Care Med Date: 2003-03-28 Impact factor: 17.440