Gene expression profiling of apoptosis regulators in patients with sepsis.

INTRODUCTION Sepsis is associated with a dysregulation of apoptosis in immune cells, which has been implicated in both immunosuppression and multiple organ failure. We describe the expression profiles of genes encoding key regulators of apoptosis in highly purified monocytes, granulocytes and CD4+ T lymphocytes. METHODS Sixteen patients with sepsis were recruited from the intensive care unit and were compared with 24 healthy controls. RNA was isolated from highly purified monocyte, granulocyte and CD4+ T-lymphocyte populations. Gene expression profiles were determined using multiplex ligation-dependent probe amplification for the simultaneous detection of 30 pro- and anti-apoptotic target genes. RESULTS Relative to healthy controls, patients with sepsis showed increased transcription of both pro- and anti-apoptotic genes in peripheral blood leukocytes. Specific monocyte, granulocyte and CD4+ T-lymphocyte mRNA profiles were identified. Anti-apoptotic profiles were found in monocytes and granulocytes, while CD4+ T lymphocytes displayed a foremost pro-apoptotic mRNA profile. CONCLUSIONS These data indicate that in patients with sepsis, the alterations in apoptosis of circulating leukocytes occur in a cell-specific manner.