Low interferon-gamma release in response to phytohemagglutinin predicts the high severity of diseases

Abstract

A clinically useful immune biomarker could potentially assist clinicians in their decision making. We stimulated T-cell proliferation to secret interferon gamma (IFN-g) by phytohemagglutinin, and then measured the production of IFN-g (mitogen value [M value]). We aimed to determine the relationship between the M value, clinical severity, and outcomes of diseases. In all, 484 patients admitted to intensive care units were enrolled in this retrospective study. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were collected within the first 24 hours. M value, C-reaction protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and routine blood tests were analyzed and collected during the study. When APACHE II scores were greater than 15 and M values were less than 6, the hospital mortality rose in a straight line. There was an inverse correlation between APACHE II score and M value (rs = -0.212, P < .001). There was a positive correlation between M value and lymphocyte numbers (b’ = 0.249, P < .001); however, there was an inverse correlation between M value and WBC (b’ = - 0.230, P < .001), and ESR (b’ = -0.100, P = .029). Neurological diseases had the greatest influence on APACHE II scores (b’ = 10.356, P < .001), whereas respiratory diseases had the greatest influence on M value (b’ = 1.933, P < .001). Furthermore, in the respiratory system, severe pneumonia had a greater influence on M value. Taking the APACHE II score as the gold standard, the area under the curve of M was 0.632 (95% confidence interval [CI] 0.575–0.690, P < .001), PCT was 0.647 (95% CI 0.589–0.705, P