Hong T.-H.Chang C.-H.Ko W.-J.Lin C.-F.Liu H.-H.LU-PING CHOWCHUN-TA HUANGSUNG-LIANG YUYIH-SHARNG CHEN2019-11-272019-11-2720141479-5876https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901626390&doi=10.1186%2f1479-5876-12-146&partnerID=40&md5=45743c9be5818697cf05d06e30a16d29https://scholars.lib.ntu.edu.tw/handle/123456789/434008Background: Sepsis causes high mortality, and the mortality due to secondary infections is even higher. No studies to date have investigated the time from the primary infection to death due to a secondary infection; similarly, the factors that are significantly different in sepsis survivors relative to non-survivors or in severe sepsis patients who suffered a late death relative to those who recover have not been explored. We hypothesized that patients who survive sepsis have a weaker pro-inflammatory response than those who do not and that the mid-term survivors (which acquire secondary infections) would have a pronounced anti-inflammatory response (making them susceptible to infection); this hypothesis was verified in this study. Methods: We examined 24 patients with severe sepsis; the patients were subdivided by outcome into early death (n = 5), mid-term survival (survival through severe sepsis but death within six months or continued hospitalization for six months, n = 6), and long-term survival (recovery and survival for more than six months, n = 13) groups. The levels of CD3+, CD4+, CD8+, and CD19+ lymphocytes were analyzed by flow cytometry, and the plasma levels of carbonic anhydrase IX (CA IX), MCP-1, IL-6, IL-7, IL-8, and IL-10 were measured by ELISA on days 0, 1, 2, and 3. A statistical comparison of the variables in the groups was conducted using a mixed model. Results: The plasma levels of MCP-1, IL-6, and IL-8 in early death and survivors were significantly different, and all had p values <0.01. The plasma levels of MCP-1, IL-6, and IL-8 were also significantly different in mid-term survivors and long-term survivors, with p values of <0.01, 0.04, and <0.01, respectively. Conclusions: Our data support the hypothesis that survivors have a weaker pro-inflammatory response than non-survivors, but the mid-term survivors did not have a more pronounced anti-inflammatory response. The levels of pro-inflammatory cytokines in the mid-term and long-term survivors were significantly different. ? 2014 Hong et al.; licensee BioMed Central Ltd.[SDGs]SDG3carbonate dehydratase IX; interleukin 10; interleukin 6; interleukin 7; interleukin 8; monocyte chemotactic protein 1; biological marker; cytokine; leukocyte antigen; adult; article; cause of death; CD19+ T lymphocyte; CD3+ T lymphocyte; CD4+ T lymphocyte; CD8+ T lymphocyte; clinical article; controlled study; disease severity; enzyme linked immunosorbent assay; female; flow cytometry; hospitalization; human; immune response; inflammation; male; protein blood level; secondary infection; sepsis; survival time; T lymphocyte; aged; blood; immunology; immunophenotyping; middle aged; sepsis; treatment outcome; Aged; Antigens, CD; Biological Markers; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunophenotyping; Male; Middle Aged; Sepsis; Treatment Outcomejournal article10.1186/1479-5876-12-146248866522-s2.0-84901626390