Decrease in circulating dendritic cells predicts fatal outcome in septic shock

Objective: Biomarkers allowing accurate early staging of septic shock patients are lacking despite their obvious interest for patient management. Experimental models of septic shock in mouse previously noted a decrease in dendritic cell numbers. The aim of the study was to find a rapid reproducible biological test for an assessment of disease severity. Design: Evaluation of peripheral blood dendritic cell counts by flow cytometry using three commercially available kits. Patients and participants: Forty-two consecutive septic shock patients were studied prospectively. Measurements and results: Early low dendritic cell counts were correlated to disease severity as assessed by Simplified Acute Physiology Score or Sequential Organ Failure Assessment and predicted fatal outcome. The correlation was still present when the results were adjusted for age. Conclusion: The monitoring of blood dendritic cell count may provide an early and valuable assessment of the severity of the host response against infection and may influence the therapeutic management of septic shock patients.