Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Immune status in sepsis: the bug, the site of infection and the severity can make the difference. | Cavaillon and Adib-Conquy Critical Care 2010 14 167 http content 14 3 167 CRITICAL CARE COMMENTARY L__ Immune status in sepsis the bug the site of infection and the severity can make the difference Jean-Marc Cavaillon and Minou Adib-Conquy See related research by Gogos etal. http content 14 3 R96 Abstract Studying a large number of patients with sepsis the Hellenic sepsis study group led by Evangello Giamarellos-Bourboulis emphasizes that the nature of the bacterial infection its origin community or nosocomial its site and its severity exert different pressures on the immune system. Their study illustrates the heterogeneity of patients with sepsis and points out that numerous key parameters of severe infection influence immune status. In a study published in this issue of Critical Care Gogos and colleagues 1 investigated the influence of the type of bacterial infection the compartment where it occurs its origin community or nosocomial and its severity sepsis versus severe sepsis or septic shock on lymphopenia on the respective number of mononuclear cell subs ets on apoptosis of circulating mononuclear cells and on HLA-DR expression on monocytes. The same group had already reported that tumor necrosis factor TNF and interleukin IL -6 production by lipopolysaccharide LPS -stimulated monocytes was lower in sepsis patients with ventilator-associated pneumonia than in patients with sepsis due to other types of infections 2 . These analyses permit clinicians to monitor sepsis patients immune status which undergoes numerous modifications gathered under the term compensatory anti-inflammatory response syndrome 3 . Lymphopenia is a hallmark of sepsis. It affects most lymphocyte subsets although some divergent observations for B lymphocytes exist 4-6 . Importantly lymphopenia is accompanied by modifications of the CD4 CD8 ratio and the relative percentage of cellular subsets. For example among lymphocytes the percentages of Treg .
