Impact of sepsis on CD4 T cell immunity

Javier Cabrera-Perez, Stephanie A. Condotta, Vladimir P. Badovinac, Thomas S Griffith

Research output: Contribution to journalReview article

70 Scopus citations

Abstract

Sepsis remains the primary cause of death from infection in hospital patients, despite improvements in antibiotics and intensive-care practices. Patients who survive severe sepsis can display suppressed immune function, often manifested as an increased susceptibility to (and mortality from) nosocomial infections. Not only is there a significant reduction in the number of various immune cell populations during sepsis, but there is also decreased function in the remaining lymphocytes. Within the immune system, CD4 T cells are important players in the proper development of numerous cellular and humoral immune responses. Despite sufficient clinical evidence of CD4 T cell loss in septic patients of all ages, the impact of sepsis on CD4 T cell responses is not well understood. Recent findings suggest that CD4 T cell impairment is a multipronged problem that results from initial sepsis-induced cell loss. However, the subsequent lymphopenia- induced numerical recovery of the CD4 T cell compartment leads to intrinsic alterations in phenotype and effector function, reduced repertoire diversity, changes in the composition of naive antigenspecific CD4 T cell pools, and changes in the representation of different CD4 T cell subpopulations (e.g., increases in Treg frequency). This review focuses on sepsis-induced alterations within the CD4 T cell compartment that influence the ability of the immune system to control secondary heterologous infections. The understanding of how sepsis affects CD4 T cells through their numerical loss and recovery, as well as function, is important in the development of future treatments designed to restore CD4 T cells to their presepsis state.

Original languageEnglish (US)
Pages (from-to)767-777
Number of pages11
JournalJournal of Leukocyte Biology
Volume96
Issue number5
DOIs
StatePublished - Nov 1 2014

Keywords

  • Apoptosis
  • Homeostatic proliferation
  • Immune suppression
  • Lymphopenia

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