Nedel W, Henrique LR, Portela LV. Why should lymphocytes immune profile matter in sepsis? World J Crit Care Med 2025; 14(2): 98791 [DOI: 10.5492/wjccm.v14.i2.98791]
Corresponding Author of This Article
Wagner Nedel, MD, PhD, Assistant Professor, Department of Intensive Care Unit, Conceição Hospital Group, Francisco Trein 596, Segundo Andar, Porto Alegre 91350200, Brazil. wagnernedel@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jun 9, 2025; 14(2): 98791 Published online Jun 9, 2025. doi: 10.5492/wjccm.v14.i2.98791
Why should lymphocytes immune profile matter in sepsis?
Wagner Nedel, Lílian R Henrique, Luis Valmor Portela
Wagner Nedel, Lílian R Henrique, Department of Intensive Care Unit, Conceição Hospital Group, Porto Alegre 91350200, Brazil
Luis Valmor Portela, Department of Biochemistry, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
Author contributions: Nedel W, Henrique LR, and Portela LV reviewed the literature and wrote the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wagner Nedel, MD, PhD, Assistant Professor, Department of Intensive Care Unit, Conceição Hospital Group, Francisco Trein 596, Segundo Andar, Porto Alegre 91350200, Brazil. wagnernedel@gmail.com
Received: July 5, 2024 Revised: December 11, 2024 Accepted: December 19, 2024 Published online: June 9, 2025 Processing time: 236 Days and 19.2 Hours
Abstract
The global incidence of critical illness has been steadily increasing, resulting in higher mortality rates thereby presenting substantial challenges for clinical management. Among these conditions, sepsis stands out as the leading cause of critical illness, underscoring the urgent need for continued research to enhance patient care and deepen our understanding of its complex pathophysiology. Lymphocytes play a pivotal role in both innate and adaptive immune responses, acting as key regulators of the balance between pro-inflammatory and anti-inflammatory processes to preserve immune homeostasis. In the context of sepsis, an impaired immunity has been associated with disrupted lymphocytic metabolic activity, persistent pro-inflammatory state, and subsequent immunosuppression. These disruptions not only impair pathogen clearance but also predispose patients to secondary infections and hinder recovery, highlighting the importance of targeting lymphocyte dysfunction in sepsis management. Moreover, studies have identified absolute lymphocyte counts and derived parameters as promising clinical biomarkers for prognostic assessment and therapeutic decision-making. In particular, neutrophil-to-lymphocyte ratio, and lymphopenia have gained recognition in the literature as a critical prognostic markers and therapeutic target in the management of sepsis. This review aims to elucidate the multifaceted role of lymphocytes in pathophysiology, with a focus on recent advancements in their use as biomarkers and key findings in this evolving field.
Core Tip: Lymphocytes are essential effectors in the immune response to sepsis, contributing to both the initial defense against infection and the regulation of inflammation during the progression to chronic organ failure. One hallmark of sepsis is a profound disruption in lymphocyte homeostasis, that may lead to the development of an immunosuppressive state. Lymphocytes counts and derived variables show significant potential as prognostic markers in sepsis, offering insight into mortality risk and the likelihood of persistent organ dysfunction.
