Association between intracellular adenosine triphosphate content of CD4 ⁺ T lymphocytes and mortality in sepsis patients: A prospective observational study.

Publisher: John Wiley and Sons Ltd Country of Publication: England NLM ID: 101635460 Publication Model: Print Cited Medium: Internet ISSN: 2050-4527 (Electronic) Linking ISSN: 20504527 NLM ISO Abbreviation: Immun Inflamm Dis Subsets: MEDLINE

Original Publication: [Oxford] : John Wiley and Sons Ltd, [2013]-

Adenosine Triphosphate*/metabolism ; Sepsis*/mortality ; Sepsis*/immunology ; Sepsis*/blood ; CD4-Positive T-Lymphocytes*/immunology ; CD4-Positive T-Lymphocytes*/metabolism; Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Biomarkers ; Prognosis ; Intensive Care Units/statistics & numerical data ; Adult

Objective: This study aimed to link intracellular adenosine triphosphate content in CD4 ⁺ T lymphocytes (CD4 ⁺ iATP) with sepsis patient mortality, seeking a new predictive biomarker for outcomes and enhanced management.
Methods: 61 sepsis patients admitted to the Intensive Care Unit between October 2021 and November 2022 were enrolled. iATP levels were gauged using whole blood CD4 ⁺ T cells stimulated with mitogen PHA-L. Based on CD4 ⁺ iATP levels (<132.24 and ≥132.24 ng/mL), patients were categorized into two groups. The primary endpoint was all-cause mortality. To identify factors associated with mortality, both univariate and multivariate Cox proportional hazard analyses were conducted.
Results: Of the patients, 40 had high CD4 ⁺ iATP levels (≥132.24 ng/mL) and 21 had low levels (<132.24 ng/mL). In a 28-day follow-up, 21 (34.4%) patients perished. Adjusting for confounders like SOFA score, APACHE II score, lactic acid, and albumin, those with low CD4 ⁺ iATP had three- to fivefold higher mortality risk compared to high CD4 ⁺ iATP patients (61.9% vs. 20.0%; hazard ratio [95% confidence interval], Model 1: 4.515 [1.276-15.974], p = .019, Model 2: 3.512 [1.197-10.306], p = .022). CD4 ⁺ iATP correlated positively with white blood cell and neutrophil counts but not with lymphocytes, CD3, and CD4 counts.
Conclusions: Low CD4 ⁺ iATP levels were associated with a higher risk of mortality in sepsis patients. Measurement of CD4 ⁺ iATP may serve as a useful tool for identifying patients at a higher risk of mortality and could potentially provide a basis for clinical treatment. Further research is warranted to fully elucidate the underlying mechanisms of this association.
(© 2024 The Author(s). Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

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Keywords: CD4+ T lymphocytes; immune function; intracellular adenosine triphosphate (iATP); mortality; prognosis; sepsis

8L70Q75FXE (Adenosine Triphosphate)
0 (Biomarkers)

Date Created: 20240611 Date Completed: 20240611 Latest Revision: 20240723

20240723

PMC11165683

10.1002/iid3.1286

38860755