{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:17:05Z","timestamp":1789863425450,"version":"4.0.1"},"reference-count":56,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,24]],"date-time":"2024-11-24T00:00:00Z","timestamp":1732406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014677","name":"University of Medicine, Pharmacy, Science and Technology \u2018George Emil Palade\u2019 of T\u00e2rgu Mure\u0219","doi-asserted-by":"publisher","award":["10126\/17.12.2020"],"award-info":[{"award-number":["10126\/17.12.2020"]}],"id":[{"id":"10.13039\/501100014677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Sepsis pathophysiology involves a dysregulated immune response to infection, excessive inflammation, and immune paralysis. This study explores the relationships between cell death biomarkers (serum-soluble levels of programmed cell death protein 1 (PD-1), programmed death ligand 1 (PD-L1), and interleukin-7 (IL-7)) and the percentages of various lymphocyte subsets in relation to the severity and progression of sepsis. This prospective, observational study included 87 critically ill patients. We monitored parameters on days 1 (sepsis was diagnosed according to the Sepsis-3 Consensus) and 5. We established an IL-7 cutoff value of 1.94 pg\/mL by comparing levels between a healthy control group and patients with sepsis (p &lt; 0.0001). Lymphopenia was observed in all patients, with negative correlations between helper T lymphocytes and cytotoxic and B lymphocytes, and positive correlations involving cytotoxic lymphocytes across all groups. We found correlations between PD-1\/PD-L1 and lymphocyte subsets. IL-7 showed a statistical correlation with PD-1 in non-survivors. Assessing lymphocyte levels shows potential as a biomarker for evaluating the progression of sepsis. Monitoring IL-7 levels could help assess survival, as low levels are associated with higher mortality risk. Monitoring IL-7 levels could help assess survival, as low levels are associated with higher mortality risk. Elevated PD-1\/PD-L1 expression impairs costimulatory signalling, reducing T cell responses and lymphopenia, which increases the risk of nosocomial infections.<\/jats:p>","DOI":"10.3390\/ijms252312612","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T03:59:01Z","timestamp":1732507141000},"page":"12612","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Role of PD-1\/PD-L1 and IL-7 in Lymphocyte Dynamics and Sepsis Progression: A Biomarker Study in Critically Ill Patients"],"prefix":"10.3390","volume":"25","author":[{"given":"Oana","family":"Coman","sequence":"first","affiliation":[{"name":"Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca-Liana","family":"Grigorescu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-1594","authenticated-orcid":false,"given":"Adina","family":"Hu\u021banu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"},{"name":"Centre for Advanced Medical and Pharmaceutical Research, Immunology, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9473-0287","authenticated-orcid":false,"given":"Anca","family":"Bac\u00e2rea","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Meda","family":"V\u0103sie\u0219iu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca \u0218tefania","family":"Fodor","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Petri\u0219or","sequence":"additional","affiliation":[{"name":"Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Azamfirei","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (SEpsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_3","first-page":"74","article-title":"Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression","volume":"9","author":"Pei","year":"2022","journal-title":"Mil. 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