ArticleCritical care (London, England)2016
T cells from patients with Candida sepsis display a suppressive immunophenotype.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 1 of them a synthesis that pooled it.
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Who cites it
77 citing papers in PubMed, 1 synthesis or guideline pooled it, 119 citations in OpenAlex.
- Procalcitonin levels in candidemia versus bacteremia: a systematic review.Critical care (London, England) · 2019Pooled it
- Development and Validation of a Risk Score for Predicting Invasive Candidiasis in Intensive Care Unit Patients by Incorporating Clinical Risk Factors and Lymphocyte Subtyping.Frontiers in cellular and infection microbiology · 2022Trial
- SARS-CoV-2-specific T cell responses and correlations with COVID-19 patient predisposition.The Journal of clinical investigation · 2020Trial
- Dual-Targeting, Hybrid Antifungal Agents Targeting Candida albicans-An Overview.Chemical biology & drug design · 2026Review
- Host-directed immune therapies: a second front in the battle against sepsis.The Journal of clinical investigation · 2026Review
- CARD9-dependent macrophage plasticity regulates effective fungal clearance.The Journal of clinical investigation · 2026Article
- Repurposing Itraconazole in Combination with Chemotherapy and Immune Checkpoint Inhibitor for Cancer.Medical sciences (Basel, Switzerland) · 2026Review
- Sepsis Endotypes Defined by Lymphocyte Thresholds and Inflammation Inform Precision Immunomodulation.MedComm · 2026Article
- Admission CD4Frontiers in cellular and infection microbiology · 2026Observational
- Identification of distinct immune subtypes in sepsis through dual immunomarker trajectory.Annals of intensive care · 2026Article
- Targeting VISTA for immunomodulation in sepsis: mechanisms and therapeutic potentials.Frontiers in immunology · 2026Review
- Emergence, function, and therapeutic strategies to target the PD-1/PD-L1 immune checkpoint during pathogenic fungal infections.Virulence · 2025Review
- Association Between Peripheral Blood Regulatory T Cell Content with Inflammatory Stress Response and Immune Response in Children with Sepsis.Molecular biotechnology · 2025Article
- Dynamic alterations of lymphocyte subsets following sepsis in octogenarian and elder patients.Journal of intensive medicine · 2025Article
- T Cell Exhaustion and Function State Correlated With Outcomes in Patients With Intra-Abdominal Candidiasis.Mycoses · 2025Article
- Immune Phenotypes in Patients With Invasive Mould Infection Support the Use of PD-1 Inhibition as Potential Treatment Option.Mycoses · 2025Observational
- Immunophenotyping of septic shock patients with endotheliopathy: focus on monocyte subtypes and Immune regulatory molecules.Frontiers in immunology · 2025Article
- T-cell exhaustion in COVID-19: what do we know?Frontiers in immunology · 2025Review
- Establishment and Validation of a Machine-Learning Prediction Nomogram Based on Lymphocyte Subtyping for Intra-Abdominal Candidiasis in Septic Patients.Clinical and translational science · 2025Article
- Lymphopenia in sepsis: a narrative review.Critical care (London, England) · 2024Review
17 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDespite appropriate therapy, Candida bloodstream infections are associated with a mortality rate of approximately 40%. In animal models, impaired immunity due to T cell exhaustion has been implicated in fungal sepsis mortality. The purpose of this study was to determine potential mechanisms of fungal-induced immunosuppression via immunophenotyping of circulating T lymphocytes from patients with microbiologically documented Candida bloodstream infections.
methodsPatients with blood cultures positive for any Candida species were studied. Non-septic critically ill patients with no evidence of bacterial or fungal infection were controls. T cells were analyzed via flow cytometry for cellular activation and for expression of positive and negative co-stimulatory molecules. Both the percentages of cells expressing particular immunophenotypic markers as well as the geometric mean fluorescence intensity (GMFI), a measure of expression of the number of receptors or ligands per cell, were quantitated.
resultsTwenty-seven patients with Candida bloodstream infections and 16 control patients were studied. Compared to control patients, CD8 T cells from patients with Candidemia had evidence of cellular activation as indicated by increased CD69 expression while CD4 T cells had decreased expression of the major positive co-stimulatory molecule CD28. CD4 and CD8 T cells from patients with Candidemia expressed markers typical of T cell exhaustion as indicated by either increased percentages of or increased MFI for programmed cell death 1 (PD-1) or its ligand (PD-L1).
conclusionsCirculating immune effector cells from patients with Candidemia display an immunophenotype consistent with immunosuppression as evidenced by T cell exhaustion and concomitant downregulation of positive co-stimulatory molecules. These findings may help explain why patients with fungal sepsis have a high mortality despite appropriate antifungal therapy. Development of immunoadjuvants that reverse T cell exhaustion and boost host immunity may offer one way to improve outcome in this highly lethal disorder.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.