https://orcid.org/0009-0008-4096-4775
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Abstract
Purpose
Immune dysfunction plays a pivotal role in sepsis pathogenesis. Previous studies have revealed the crucial role of T cells and human leukocyte antigen-DR (HLA-DR) in sepsis. However, the function of natural killer (NK) cells remains unclear. This study aimed to investigate whether NK cells are associated with sepsis prognosis. In addition, we aimed to explore the interrelation and influence between NK and other immunological features in patients with sepsis.
Patients and Methods
This retrospective, observational study included patients with sepsis from two hospitals in mainland China. The clinical characteristics and immune results during the early phase were collected. Patients were classified according to the level of immune cells to analyze the relationship between immunological features and 28-day mortality.
Results
A total of 984 patients were included in this study. Non-survivors were older and had lower levels of lymphocytes, monocytes, NK cells, HLA-DR, and T cells. Patients were classified into eight groups according to their levels of NK cells, HLA-DR, and T cells. Only patients with decreased NK and T cell counts showed a significant increase in 28-day mortality. An increase in CD8+ T cells was correlated with the alleviation of 28-day mortality only among patients with high NK cell levels.
Conclusion
This study provides novel insights into the association between NK cells and 28-day mortality as well as the interrelation between NK cells and other immune cells in sepsis. The relationship between CD8+ T cells and 28-day mortality in sepsis is dependent on NK cell count.
Abbreviations
ICU, intensive care unit; NK cell, natural killer cell; HLA-DR, human leukocyte antigen-DR; SOFA, sequential organ failure assessment; APACHE, Acute Physiology and Chronic Health Evaluation.
Data Sharing Statement
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Ethics Approval and Consent to Participate
The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Zhongda Hospital, Southeast University.
Consent for Publication
The informed consent was waived for the following reasons: 1) The study uses medical record data obtained from previous clinical consultations, and the risk to the subject is not greater than the minimum risk, and the exemption of informed consent will not adversely affect the rights and health of the subject; 2) The information collected by the Institute ensures that the privacy and identity of the subjects is confidential and protected; 3) The study does not utilize medical records and specimens that the patient/subject has previously expressly refused to use. Waiver of informed consent statement was shown in the file named “Waiver of informed consent statement”.
Acknowledgments
We acknowledge that all the participants participated in this study.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflict of interest in this work.