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Commentary

To be, or not to be immunocompetent

Hans-Dieter Volk12* and Petra Reinke23

Author Affiliations

1 Institute of Medical Immunology, Charité – University Medicine Berlin, D-13353, Berlin, Germany

2 Berlin-Brandenburg Center for Regenerative Therapies, Charité – University Medicine Berlin, D-13353, Berlin, Germany

3 Department of Nephrology and Internal Intensive Care, Charité – University Medicine Berlin, D-13353, Berlin, Germany

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Critical Care 2013, 17:185  doi:10.1186/cc12897


See related research by Chang et al., http://ccforum.com/content/17/3/R85

Published: 13 September 2013

Abstract

Several data support the view that impairment of the inflammatory-immune response is a hallmark of severe sepsis and the level and time of recovery to immunocompetence has a major impact on the clinical outcome of ICU patients. Recent studies demonstrate that improvement of anti-tumour immune response by targeting negative regulatory molecules, such as CD25, chronic T-lymphocyte activation antigen 4, and programmed death-1 receptor (PD-1)/PD-1 L, offers a novel opportunity to prevent or even reverse progression of tumour growth in experimental models and patients. Likewise, severe sepsis is associated with enhanced expression of those negative regulatory molecules, suggesting a novel approach to reverse immunoparalysis in sepsis. Consequently, targeting negative molecules in sepsis can reverse immunoparalysis and improve survival in experimental sepsis, as shown by Chang and colleagues in a recent issue of Critical Care. This opens new opportunities to overcome overwhelming downregulation of the adaptive immune response to prevent and/or improve recovery from sepsis.