• Christian Krautz, Sarah L Maier, Maximilian Brunner, Melanie Langheinrich, Evangelos J Giamarellos-Bourboulis, Charalambos Gogos, Apostolos Armaganidis, Frank Kunath, Robert Grützmann, and Georg F Weber.
• Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Germany.
• J Crit Care. 2018 Jun 1; 45: 71-75.

BackgroundB cell function and antibody production are crucial factors in host protection during inflammation. We aimed to synthesize the available evidence on the association between the reduction of circulating B cells and plasma immunoglobulin (IgM) levels and decreased survival during sepsis.MethodsWe performed a systematic search in PubMed, Embase, ISI Web of Knowledge, Cochrane Central Register of Controlled Trials, BioMed Central, and Science Direct. We selected studies with data on circulating B cells and plasma IgM levels within the initial 24 h after sepsis onset.ResultsIn total nine studies (n = 992 patients) were identified. Circulating B cells were reduced in septic patients as compared to non-septic patients (mean difference [MD] -88.2 cells/μl; 95% confidence interval [CI] -148.6--27.9). Sepsis non-survivors showed a significant reduction of circulating B cells and IgM levels compared to sepsis survivors (MD -77.1 cells/μl; 95% CI -111.4--42.7 and MD -20.9 mg/dl; 95% CI -33.8--8.0, respectively).ConclusionsOur results suggest that a reduction of circulating B cells and IgM levels at sepsis onset are associated with decreased sepsis survival. However, due to methodological limitations and the risk of bias, we need further prospective studies to confirm this association.RegistrationThe protocol was registered (PROSPERO 2016:CRD42016053184).Copyright © 2018 Elsevier Inc. All rights reserved.

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