PMID- 38180532 OWN - NLM STAT- MEDLINE DCOM- 20240429 LR - 20240429 IS - 1938-3673 (Electronic) IS - 0741-5400 (Linking) VI - 115 IP - 5 DP - 2024 Apr 29 TI - Decreased percentages of plasmacytoid dendritic cells predict survival in critically ill patients. PG - 902-912 LID - 10.1093/jleuko/qiae003 [doi] AB - Critically ill patients admitted to intensive care units (ICUs) experience a broad variety of life-threatening conditions. Irrespective of the initial cause of hospitalization, many experience systemic immune dysregulation. Dendritic cells (DCs) are the most potent antigen-presenting cells and play a pivotal role in regulating the immune response by linking the innate to the adaptive immune system. The aim of this study was to analyze whether DCs or their respective subsets are associated with 30-d mortality in an unselected patient cohort admitted to a medical ICU with a cardiovascular focus. A total of 231 patients were included in this single-center prospective observational study. Blood was drawn at admission and after 72 h. Subsequently, flow cytometry was utilized for the analysis of DCs and their respective subsets. In the total cohort, low percentages of DCs were significantly associated with sepsis, respiratory failure, and septic shock. In particular, a significantly lower percentage of circulating plasmacytoid DCs (pDCs) was found to be a strong and independent predictor of 30-d mortality after adjustment for demographic and clinical variables with an hazard ratio of 4.2 (95% confidence interval: 1.3-13.3, P = 0.015). Additionally, low percentages of pDCs were correlated with additional markers of inflammation and organ dysfunction. In conclusion, we observed low percentages of DCs in patients admitted to an ICU experiencing sepsis, respiratory failure, and cardiogenic shock, suggesting their depletion as a contributing mechanism for the development of immune paralysis. In our cohort, pDCs were identified as the most robust subset to predict 30-d mortality. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of Society for Leukocyte Biology. FAU - Steinacher, Eva AU - Steinacher E AUID- ORCID: 0000-0001-7816-8354 AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Lenz, Max AU - Lenz M AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. AD - Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Krychtiuk, Konstantin A AU - Krychtiuk KA AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Hengstenberg, Christian AU - Hengstenberg C AUID- ORCID: 0000-0002-8284-2994 AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Huber, Kurt AU - Huber K AUID- ORCID: 0000-0002-7934-5524 AD - Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Guertel 18-20, 1090 Vienna, Austria. AD - 3rd Medical Department for Cardiology and Emergency Medicine, Wilhelminenhospital, Montleartstrasse 37, 1160 Vienna, Austria. AD - Medical Faculty, Sigmund Freud University, Freudplatz 1, 1020 Vienna, Austria. FAU - Wojta, Johann AU - Wojta J AUID- ORCID: 0000-0002-1282-9276 AD - Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Guertel 18-20, 1090 Vienna, Austria. AD - Core Facilities, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Heinz, Gottfried AU - Heinz G AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Niessner, Alexander AU - Niessner A AUID- ORCID: 0000-0001-8888-0935 AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Speidl, Walter S AU - Speidl WS AUID- ORCID: 0000-0002-7267-3138 AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. AD - Ludwig Boltzmann Institute for Cardiovascular Research, Waehringer Guertel 18-20, 1090 Vienna, Austria. FAU - Koller, Lorenz AU - Koller L AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. LA - eng GR - Association for the Promotion of Research on Arteriosclerosis, Thrombosis and Vascular Biology/ GR - Ludwig Boltzmann Institute for Cardiovascular Research/ PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't PL - England TA - J Leukoc Biol JT - Journal of leukocyte biology JID - 8405628 SB - IM MH - Humans MH - *Dendritic Cells/immunology MH - *Critical Illness/mortality MH - Male MH - Female MH - Aged MH - Middle Aged MH - Prospective Studies MH - Intensive Care Units MH - Prognosis OTO - NOTNLM OT - SIRS OT - Toll-like receptors OT - critical care OT - dendritic cells OT - plasmacytoid dendritic cells COIS- Conflict of interest: The authors declare no conflict of interest. EDAT- 2024/01/05 12:43 MHDA- 2024/04/30 04:21 CRDT- 2024/01/05 11:06 PHST- 2023/06/21 00:00 [received] PHST- 2023/12/04 00:00 [revised] PHST- 2023/12/19 00:00 [accepted] PHST- 2024/04/30 04:21 [medline] PHST- 2024/01/05 12:43 [pubmed] PHST- 2024/01/05 11:06 [entrez] AID - 7511654 [pii] AID - 10.1093/jleuko/qiae003 [doi] PST - ppublish SO - J Leukoc Biol. 2024 Apr 29;115(5):902-912. doi: 10.1093/jleuko/qiae003.