Effect of pulse high volume hemofiltration on CD4~+CD25~+ Treg cells in patients with sepsis

Objective:To study the level and significance of CD4+CD25+ Treg cells and CD3+,CD4+,CD8+ cells in peripheral blood of patients with sepsis and evaluate the effects of pulse high volume hemofiltration(PHVHF)on them.Methods:Forty patients with sepsis in ICU of Anhui Provicial Hospital were studied from January 2008 to November 2010.Patients were divided into three groups:sepsis group(n=14),severe sepsis group(n=15)and septic shock group(n=11).The expressions of CD4+CD25+ Treg cells and CD3+,CD4+,CD8+ cells of 40 patients on the day 1 and day 5 were detected by flow cytometry and were compared.Twenty five patients receiving PHVHF were divided into two groups:death group(n=7)and survive group(n=18).Twenty healthy individuals served as controls.Results:The expressions of CD4+CD25+ Treg cells were the highest in septic shock group(3.55±0.51%),followed by the severe sepsis group(2.72±0.22%) and the sepsis group(1.72±0.59%).There were significant differences among the three groups(all P0.05).The level of CD3+,CD4+ and CD4+/CD8+ in sepsis group was higher than control group(P0.05)and the level of CD3+、CD4+ and CD4+/CD8+ in severe sepsis and sepsis shock were lower than control group(P0.05).Compared with death group,PHVHF could decrease the abnormal expression of CD4+CD25+ Treg cells and increase the level of CD3+,CD4+ and CD4+/CD8+ in survive group.Conclusion:CD4+CD25+ Treg cells may play an important role in pathogenesis of sepsis.PHVHF could rebuild immunologic balance and to be used in the treatment of sepsis patients.