ePoster Presentation 49th Annual Scientific Meeting of the Australian and New Zealand Society for Immunology 2021

Immunophenotyping of peripheral blood mononuclear cells in septic shock patients with high-dimensional flow cytometry analysis reveals two subgroups with differential responses to immunostimulant drugs (#177)

Ya Wang 1 2 , Brian Gloss 3 , Benjamin Tang 1 2 , Suat Dervish 4 , Brigitte S Nanan 5 , Christina Whitehead 1 , Kristy Masters 1 , Kristen Skarratt 6 , Sally Teoh 1 , Stephen Schibeci 2 , Nicole Fewings 2 , Chrystelle Brigone 7 , Frederic Triebel 7 , David Booth 2 , Anthony McLean 1 , Marek Nalos 1 8
  1. Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia
  2. Centre for Immunology and Allergy Research, Westmead Institute for Medical Research, Westmead, NSW, Australia
  3. Westmead Research Hub, Westmead Institute for Medical Research, Westmead, NSW, Australia
  4. Westmead Cytometry, Westmead Institute for Medical Research, Westmead, NSW, Australia
  5. Sydney Medical School Nepean, Charles Perkins Centre Nepean, University of Sydney, Kingswood, NSW, Australia
  6. Department of Medicine, Faculty of Medicine and Health, University of Sydney, Nepean Clinical School, Kingswood, NSW, Australia
  7. Immutep, S.A.S, Parc Club Orsay, France
  8. Department of Medicine, Charles University, Medical Faculty in Plzen, Prague, Czech Republic

Sepsis is associated with a dysregulated inflammatory response to infection. Despite the activation of inflammation, an immune suppression is often observed, predisposing patients to secondary infections. Therapies directed at restoration of immunity may be considered but should be guided by the immune status of the patients. In this paper, we described the use of a high-dimensional flow cytometry (HDCyto) panel to assess the immunophenotype of patients with sepsis. We then isolated peripheral blood mononuclear cells (PBMCs) from patients with septic shock and mimicked a secondary infection by stimulating PBMCs for 4 hours in vitro with lipopolysaccharide (LPS) with or without prior exposure to either IFN-γ, or LAG-3Ig. We evaluated the response by means of flow cytometry and high-resolution clustering cum differential analysis and compared the results to PBMCs from healthy donors. We observed a heterogeneous immune response in septic patients and identified two major subgroups: one characterized by hypo-responsiveness (Hypo) and another one by hyper-responsiveness (Hyper). Hypo and Hyper groups showed significant differences in the production of cytokines/chemokine and surface human leukocyte antigen-DR (HLA-DR) expression in response to LPS stimulation, which were observed across all cell types. When pre-treated with either interferon gamma (IFN-γ) or lymphocyte-activation gene 3 (LAG)-3 recombinant fusion protein (LAG-3Ig) prior to LPS stimulation, cells from the Hypo group were shown to be more responsive to both immunostimulants than cells from the Hyper group. Our results demonstrate the importance of patient stratification based on their immune status prior to any immune therapies. Once sufficiently scaled, this approach may be useful for prescribing the right immune therapy for the right patient at the right time, the key to the success of any therapy.