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Impaired Granuloma Formation in Sepsis: Impact of Monocytopenia
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Edité par CCSD ; Public Library of Science -
International audience. Granulomas are a collection of immune cells considered to be protective ă in infectious diseases. The in vitro generation of granulomas is an ă interesting substitution to invasive approaches of granuloma study. The ă monitoring of immune response through the determination of in vitro ă granuloma formation in patients with severe sepsis may be critical to ă individualize treatments. We compared the in vitro generation of ă granulomas by co-culturing circulating mononuclear cells from 19 ă patients with severe sepsis, 9 patients cured from Q fever and 12 ă healthy subjects as controls, and Sepharose beads coated either with BCG ă or Coxiella burnetii extracts to analyze both immune and innate ă granulomas, respectively. We showed that the great majority of patients ă with severe sepsis were unable to form granulomas in response to BCG and ă C. burnetii extracts whereas more than 80% of healthy controls and ă patients cured from Q fever formed granulomas. We also found that ă monocytopenia and defective production of tumor necrosis factor were ă associated with reduced formation of granulomas in patients with severe ă sepsis even if TNF did not seem to be involved in the defective ă granuloma formation. Taken together, these results suggest that the ă deficiency of granuloma formation may be a measurement of altered ă recruitment and activation of monocytes and lymphocytes in patients with ă severe sepsis.
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