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Increased percentage of CD4+CD25+ regulatory T cells during septic shock is due to the decrease of CD4+CD25- lymphocytes.

Fabienne Venet·Alexandre Pachot·Anne-Lise Debard·Julien Bohé·Jacques Bienvenu·Alain Lepape·Guillaume Monneret
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Abstract

OBJECTIVE: The elevation of the percentage of regulatory CD4+CD25+ T lymphocytes (Treg) has been recently described during septic shock. The objective of the present study was to investigate whether this increased percentage was due to Treg proliferation. DESIGN: Observational study. SETTING: Adult intensive care units in a university hospital. SUBJECTS: Patients with septic shock (n = 54) and healthy individuals (n = 30). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In patients, we first confirmed the increased percentage of Treg among CD4+ lymphocytes in comparison with healthy individuals. Surprisingly, regarding absolute counting, we demonstrated that both T CD4+ lineages (CD25+ and CD25-) were diminished immediately after the onset of shock. Then, whereas Treg returned rapidly to healthy donors values, CD4+CD25- T lymphocytes remained dramatically reduced. Finally, Foxp3 (Treg-related gene) messenger RNA quantification enabled us to definitively rule out a lack of proliferation since it was not increased during shock. CONCLUSION: The increased percentage of Treg after shock is due not to their proliferation but to a decrease in CD4+CD25- T lymphocyte number. We hypothesize that it might be due to a resistance of Treg to apoptosis processes occurring during septic shock.

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APACHEAdultAgedAged, 80 and overAntigens, CDAntigens, Differentiation, T-LymphocyteApoptosisCD4 Lymphocyte CountCD4-Positive T-LymphocytesCase-Control StudiesCell DifferentiationCell LineageDNA-Binding ProteinsFemaleFlow CytometryForkhead Transcription FactorsHumansImmune ToleranceImmunophenotypingLectins, C-TypeLeukocyte Common AntigensMaleMiddle AgedReceptors, Interleukin-2Reverse Transcriptase Polymerase Chain ReactionShock, SepticStatistics, NonparametricT-Lymphocytes, RegulatoryTime FactorsCD69 AntigensJournal Article

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Fabienne Venet, Alexandre Pachot, Anne-Lise Debard, Julien Bohé, Jacques Bienvenu, Alain Lepape, Guillaume Monneret. 2004. Increased percentage of CD4+CD25+ regulatory T cells during septic shock is due to the decrease of CD4+CD25- lymphocytes.. https://doi.org/10.1097/01.ccm.0000145999.42971.4b

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