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Animal studies have suggested that severe sepsis is characterized by a two-phase immune response, in which an initial period of cytokine-mediated hyperinflammation is followed by a period of immunosuppression. However, definitive evidence of an immunosuppressive state in humans with sepsis has been lacking. To explore this issue, researchers studied spleen and lung tissue in early postmortem samples from 40 patients who died of sepsis and in postmortem or operative tissue samples (29 spleens and 20 lungs from control patients without sepsis).
Sepsis patients were older and had more comorbidities than controls; the median duration of sepsis was 4 days (range, 1 to >40 days). When stimulated by lipopolysaccharide or with anti-CD3/anti-CD28 ant…