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Table 9 Experimental conduct and exclusion criteria of lymphocyte apoptosis studies
| Author | Study population | Sample timing | Definition of sepsis | Microbiology results provided | Independent adjudication of sepsis diagnosis | Exclusion criteria immunosuppressive disease | Exclusion criteria malignancy | Primary conclusion of study (in relation to lymphocyte apoptosis) | |
|---|---|---|---|---|---|---|---|---|---|
| Time of first sample | No. samples (time span) | ||||||||
| Roger [43] | Sepsis | Before first abs | 1 | 3 B C | Y | Y | Y | Y | Concomitant T cell proliferation and T cell apoptosis are observed in human sepsis |
| Bandyopadhyay [58] | Trauma | ? | Every 4 days (28 days) | N | N | N | Y | N | CD47 triggering, SHP-1 mediated NFkB suppression and elevated TRAIL levels increase…T cell apoptosis |
| White [11] | Sepsis | 24 h (ICU adm/positive BC) | 2 (7 days) | 1 B C | N | Y | Y | N | Patients with infection and sepsis have deficient IL-2 and IL-7 gene expression |
| White [11] | Elective surgery (infective complications) | Pre-insult | 3 (5 days) | 4 | N | Y | Y | N | |
| Zhang [44] | Sepsis | 24 h (sep shock) | 1 | 1C | N | N | Y | N | The expression of PD-1 on T cells [is] up regulated in septic shock |
| Guignant [45] | Sepsis | 48 h (sep shock) | 3 (10 days) | 1C | Y | Y | N | Y | PD-1 related molecules may constitute a novel immunoregulatory system involved in sepsis-induced immune alterations |
| Vaki [46] | Sepsis | 12 h (organ failure) | 2 B C | Y | Y | Y | N | These findings support…the existence of an early circulating factor in severe sepsis/shock, modulating apoptosis of CD4 lymphocytes | |
| Slotwinski [62] | Elective surgery | Pre-insult | 4 (7 days) | N | N | N | Y | N | Preoperative enteral immunonutrition prevents postoperative decrease in lymphocyte subsets |
| Gogos [47] | Sepsis | 24 h (signs of sepsis) | 1 | 2 B C | Y | Y | Y | N | Major differences of the early statuses of innate and adaptive immune systems exist between sepsis and severe sepsis/shock in relation the underlying type of infection |
| Hoogerwerf [48] | Sepsis | 24 h (dx sepsis) | 1 | 2 A | Y | Y | Y | N | In patients with sepsis, alterations in apoptosis of circulating leukocytes occur in a cell-specific manner |
| Yousef [49] | Sepsis | ? | 1 | 1 A B C | N | N | Y | N | Percentage of apoptotic lymphocyte median values [could be] an indicator of prognosis and survival in critically ill patients |
| Turrel-Davin [50] | Sepsis | 48 h (sep shock) | 2 (5 days) | 1C | Y | Y | N | N | Pro-apoptotic genes BID and FAS appear to constitute promising apoptosis markers |
| Pelekanou [51] | Sepsis | 24 h (signs of sepsis) | 1 | 1 2 A B C | Y | Y | Y | N | Decrease of CD-4 lymphocytes…is characteristic of sepsis arising in ventilator associated pneumonia |
| Papadima [61] | Elective surgery | Pre-insult | 2 (1 day) | N | - | Y | Y | No alterations in lymphocyte counts [and] subpopulations [following use of epidural anaesthesia] | |
| Delogu [52] | Sepsis | 24 h (sep shock) | 1 | ? C | Y | N | N | N | Blood caspase-1 elevated in sepsis. IL-6 correlates with apoptotic rate and caspase-9 expression in lymphocytes |
| Weber [53] | Sepsis | 4 h (sev sepsis) | 1 | 1 B | N | N | Y | Y | In early severe sepsis…induction of…Bim,Bid,Bak and downregulation of Bcl-2 and Bcl-xl is observed |
| Roth [54] | Sepsis | ? | 1 | 1 A B C | N | N | N | N | These findings strongly suggest that in septic patients Th1 T cells are selectively susceptible to apoptosis |
| Le Tulzo [55] | Sepsis | +ve microbiology ±3 days | 2 (6 days) | 1 B C E | Y | N | N | N | Lymphocyte apoptosis is rapidly increased in…septic shock…and leads to a profound and persistent lymphopaenia associated with poor outcome |
| Hotchkiss [56] | Sepsis | 6 h (death) | 1 | 6 | Y | N | Y | N | Capsase 9 mediates profound progressive loss of B and CD4 T helper cells in [severe] sepsis |
| Delogu [63] | Elective surgery | Pre-insult | 3 (4 days) | N | N | N | Y | Y | Surgical trauma is associated with a significant but transient increase in lymphocyte commitment to apoptosis |
| Pellegrini [59] | Trauma | ? | 2/week (until death/discharge) | N | N | N | N | N | Increased levels of apoptosis are not directly associated with negative trauma patient outcome |
| Delogu [64] | Surgical | Pre-insult | 3 (4 days) | N | N | N | Y | Y | Surgical trauma upregulates lymphocyte death signalling factors and downregulates survival factors. Increased apoptosis of CD8+ cells maybe associated with greater risk of postsurgical infection |
| Hotchkiss [60] | Trauma | 10 h (injury to surgery) | 1 | N | N | N | N | N | Focal apoptosis of intestinal epithelial and lymphoid tissues occurs extremely rapidly after injury |
| Hotchkiss [57] | Sepsis | 6 h (death) | 1 | 6 | Y | Y | N | N | Caspase-3 mediated apoptosis causes extensive lymphocyte apoptosis in sepsis |
| Sasajima [65] | Elective surgery | Pre-insult | 5 (7 days) | N | N | N | N | N | Transient T cell apoptosis occurs after major operations |
| Sugimoto [66] | Elective surgery | Pre-insult | 4 (4 days) | N | N | N | N | N | Enhanced FasL expression is likely to be related to systemic inflammatory responses induced during the perioperative period |
