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Blood, 15 November 2007, Vol. 110, No. 10, pp. 3673-3681.
Prepublished online as a Blood First Edition Paper on August 9, 2007; DOI 10.1182/blood-2007-04-087171.
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Submitted April 25, 2007
Accepted July 30, 2007
Treatment with GITR agonistic antibody corrects adaptive immune dysfunction in sepsis
Philip O Scumpia, Matthew J Delano, Kindra M Kelly-Scumpia, Jason S Weinstein, James L Wynn, Robert D Winfield, Changqing Xia, Chun Shiang Chung, Alfred Ayala, Mark A Atkinson, Westley H Reeves, Michael J Clare-Salzler, and Lyle L Moldawer*
Department of Surgery, University of Florida College of Medicine, Gainesville, Fl, United States
Department of Medicine, University of Florida College of Medicine, Gainesville, Fl, United States
Department of Pathology, University of Florida College of Medicine, Gainesville, Fl, United States
Division of Surgical Research/Department of Surgery, Rhode Island Hospital and Brown University School of Medicine, Providence, RI, United States
* Corresponding author; email: moldawer{at}surgery.ufl.edu.
Apoptosis of CD4+ T cells and TH2 polarization are hallmarks of sepsis-induced immunoparalysis. In this study, we characterized sepsis-induced adaptive immune dysfunction and examined whether improving T cell effector function could improve outcome to sepsis. We found that septic mice produced less antigen specific T cell dependent IgM and IgG2a antibodies than sham-treated mice. As early as 24 hours after sepsis, CD4+ T cells proliferated poorly to T cell receptor stimulation, despite normal responses to phorbol myristate acetate and ionomycin, and possessed decreased levels of CD3 . Five days following immunization, CD4+ T cells from septic mice displayed decreased antigen specific proliferation and production of IL-2 and IFN- , but showed no difference in IL-4, IL-5, or IL-10 production. Treatment of mice with anti-GITR agonistic antibody restored CD4+ T cell proliferation, increased TH1 and TH2 cytokine production, partially prevented CD3 downregulation, decreased bacteremia, and increased sepsis survival. Depletion of CD4+ T cells but not CD25+ regulatory T cells eliminated the survival benefit of anti-GITR treatment. These results indicate that CD4+ T cell dysfunction is a key component of sepsis, and that improving T cell effector function may be protective against sepsis-associated immunoparalysis.

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J. L. Wynn, P. O. Scumpia, R. D. Winfield, M. J. Delano, K. Kelly-Scumpia, T. Barker, R. Ungaro, O. Levy, and L. L. Moldawer
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[Abstract]
[Full Text]
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