Insights into Immunodeficiency in Sepsis

Survivors of the initial hyperinflammatory state of severe sepsis often develop a state of profound immunodeficiency. This deficiency may predispose to secondary infections or reactivation of latent endogenous viruses and contribute to long-term morbidity and mortality. However, the characteristics of this immunocompromised state in septic patients are ill-defined so far. Two recent investigations shed some light on this issue.

Hoogendijk and colleagues investigated 19 critically ill septic patients (mean SOFA score, 8) and 19 age- and gender-matched controls. Septic patients had marked reduction of cytokine production after ex vivo stimulation of a whole blood sample with lipopolysaccharide. Intracellular proinflammatory signaling was signi…