Immunological risk factors for sepsis-associated delirium and mortality in ICU patients

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Abstract

Background

A major challenge in intervention of critical patients, especially sepsis-associated delirium (SAD) intervention, is the lack of predictive risk factors. As sepsis and SAD are heavily entangled with inflammatory and immunological processes, to identify the risk factors of SAD and mortality in the intensive care unit (ICU) and determine the underlying molecular mechanisms, the peripheral immune profiles of patients in the ICU were characterized.

Methods

This study contains a cohort of 52 critical patients who were admitted to the ICU of the First Affiliated Hospital of Jinan University. Comorbidity, including sepsis and SAD, of this cohort was diagnosed and recorded. Furthermore, peripheral blood samples were collected on days 1, 3, and 5 of admission for peripheral immune profiling with blood routine examination, flow cytometry, ELISA, RNA-seq, and qPCR.

Results

The patients with SAD had higher mortality during ICU admission and within 28 days of discharge. Compared with survivors, nonsurvivors had higher neutrophilic granulocyte percentage, higher CRP concentration, lower monocyte count, lower monocyte percentage, lower C3 complement level, higher CD14 ^loCD16 ⁺ monocytes percentage, and higher levels of IL-6 and TNFα. The CD14 ^hiCD16 ^- monocyte percentage manifested favorable prediction values for the occurrence of SAD. Differentially expressed genes between the nonsurvival and survival groups were mainly associated with immune response and metabolism process. The longitudinal expression pattern of SLC2A1 and STIMATE were different between nonsurvivors and survivors, which were validated by qPCR.

Conclusions

Nonsurvival critical patients have a distinct immune profile when compared with survival patients. CD14 ^hiCD16 ^- monocyte prevalence and expression levels of SLC2A1 and STIMATE may be predictors of SAD and 28-day mortality in ICU patients.

Related collections

Most cited references 38

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Author and article information

Contributors

Zhiyao Ren: URI : https://loop.frontiersin.org/people/1903408

Jun Su: URI : https://loop.frontiersin.org/people/1625590

Jieping Deng: URI : https://loop.frontiersin.org/people/738524

Chanchan Xiao: URI : https://loop.frontiersin.org/people/884463

Pengcheng Wang: URI : https://loop.frontiersin.org/people/659925

Oscar Junhong Luo: URI : https://loop.frontiersin.org/people/1029478

Guobing Chen: URI : https://loop.frontiersin.org/people/86952

Zhigang Wang: URI : https://loop.frontiersin.org/people/1625515

Journal

Journal ID (nlm-ta): Front Immunol

Journal ID (iso-abbrev): Front Immunol

Journal ID (publisher-id): Front. Immunol.

Title: Frontiers in Immunology

Publisher: Frontiers Media S.A.

ISSN (Electronic): 1664-3224

Publication date (Electronic): 20 September 2022

Publication date Collection: 2022

Volume: 13

Electronic Location Identifier: 940779

Affiliations

[1] ¹ Department of Microbiology and Immunology, School of Medicine, Jinan University , Guangzhou, China

[2] ² Institute of Geriatric Immunology, School of Medicine, Jinan University , Guangzhou, China

[3] ³ Guangdong-Hong Kong-Macau Great Bay Area Geroscience Joint Laboratory, Jinan University , Guangzhou, China

[4] ⁴ Department of Systems Biomedical Sciences, School of Medicine, Jinan University , Guangzhou, China

[5] ⁵ National Health Commission (NHC) Key Laboratory of Male Reproduction and Genetics , Guangzhou, China

[6] ⁶ Department of Central Laboratory, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital) , Guangzhou, China

[7] ⁷ Department of Sonograph, The First Affiliated Hospital, Jinan University , Guangzhou, China

[8] ⁸ Department of Critical Care Medicine, The First Affiliated Hospital, Jinan University , Guangzhou, China

Author notes

Edited by: Steven O'Reilly, STipe Therapeutics, Denmark

Reviewed by: Roshni Roy, National Institute on Aging (NIH), United States; Paula Trzepacz, Indiana University Bloomington, United States

*Correspondence: Zhigang Wang, drwangzg@ 123456sina.com ; Guobing Chen, guobingchen@ 123456jnu.edu.cn ; Oscar Junhong Luo, luojh@ 123456jnu.edu.cn

†These authors have contributed equally to this work and share first authorship

This article was submitted to Systems Immunology, a section of the journal Frontiers in Immunology

Article

DOI: 10.3389/fimmu.2022.940779

PMC ID: 9531264

PubMed ID: 36203605

SO-VID: f43455e9-b3e3-4b8a-9dbc-0df287546966

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 10 May 2022

Date accepted : 22 August 2022

Page count

Figures: 4, Tables: 2, Equations: 0, References: 38, Pages: 13, Words: 6377

Funding

Funded by: National Key Research and Development Program of China , doi 10.13039/501100012166;

Award ID: 2018YFC2002003

Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;

Award ID: U1801285, 81971301, 32050410285

Funded by: Basic and Applied Basic Research Foundation of Guangdong Province , doi 10.13039/501100021171;

Award ID: 2020A1515010538

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Immunological risk factors for sepsis-associated delirium and mortality in ICU patients

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Abstract

Background

Methods

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Gamma Delta T cells

Most cited references 38

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Severe Sepsis and Septic Shock

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Cited by 7

Most referenced authors 968