Why should lymphocytes immune profile matter in sepsis?

Wagner Nedel, Lílian R Henrique, Luis Valmor Portela
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Abstract

The global incidence of critical illness has been steadily increasing, resulting in higher mortality rates thereby presenting substantial challenges for clinical management. Among these conditions, sepsis stands out as the leading cause of critical illness, underscoring the urgent need for continued research to enhance patient care and deepen our understanding of its complex pathophysiology. Lymphocytes play a pivotal role in both innate and adaptive immune responses, acting as key regulators of the balance between pro-inflammatory and anti-inflammatory processes to preserve immune homeostasis. In the context of sepsis, an impaired immunity has been associated with disrupted lymphocytic metabolic activity, persistent pro-inflammatory state, and subsequent immunosuppression. These disruptions not only impair pathogen clearance but also predispose patients to secondary infections and hinder recovery, highlighting the importance of targeting lymphocyte dysfunction in sepsis management. Moreover, studies have identified absolute lymphocyte counts and derived parameters as promising clinical biomarkers for prognostic assessment and therapeutic decision-making. In particular, neutrophil-to-lymphocyte ratio, and lymphopenia have gained recognition in the literature as a critical prognostic markers and therapeutic target in the management of sepsis. This review aims to elucidate the multifaceted role of lymphocytes in pathophysiology, with a focus on recent advancements in their use as biomarkers and key findings in this evolving field.

为什么淋巴细胞免疫谱在败血症中很重要?
全球重症发病率一直在稳步上升,导致死亡率上升,从而对临床管理提出了重大挑战。在这些疾病中,败血症是危重疾病的主要原因,强调迫切需要继续研究以加强患者护理并加深我们对其复杂病理生理的理解。淋巴细胞在先天和适应性免疫反应中发挥关键作用,作为促炎和抗炎过程平衡的关键调节因子,以保持免疫稳态。在脓毒症的情况下,免疫功能受损与淋巴细胞代谢活性紊乱、持续的促炎状态和随后的免疫抑制有关。这些破坏不仅损害病原体清除,而且使患者易发生继发性感染并阻碍康复,突出了针对淋巴细胞功能障碍在败血症管理中的重要性。此外,研究已经确定绝对淋巴细胞计数和衍生参数作为预后评估和治疗决策的有希望的临床生物标志物。特别是中性粒细胞与淋巴细胞的比例和淋巴细胞减少症已经在文献中被认为是脓毒症治疗的关键预后指标和治疗靶点。本文旨在阐明淋巴细胞在病理生理中的多方面作用,重点介绍其作为生物标志物的最新进展和这一不断发展的领域的主要发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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