WHO recommended TLC threshold values for severe immuno-suppression of 4000, 3000, 2500 and 2000 cells/mm3 for age categories <12, 12-35, 36-59 and >59 months had low sensitivity of 25%, 23%, 33% and 62% respectively in predicting severe immuno-suppression using CD4 count as gold standard.
Given that HIV is uniformly fatal in the absence of interventions, improved sensitivities for the raised TLC threshold favors the use of TLC as a screening tool for severe immuno-suppression in settings where CD4 monitoring is not easily accessible.
The excess of IL-10 production in trauma patients or other critically ill patients determined by the -1082G allele could be responsible for inducing immuno-suppression and subsequently developing bacterial sepsis and MODS.
Importantly, much lower levels of LPS were detected in extracts from herbs historically used for immuno-suppression (Urtica, and Tylophora).
Anti-PD-L1 antibody administration may be a promising therapeutic strategy for sepsis-induced immuno-suppression.
The suppressive activity of MDSCs separated from MM patients has also been tested (110,112 114) and the expression of ARG1 and iNOS reported as responsible for MDSC-mediated immuno-suppression (112).
This resulted in improved mean sensitivity of the TLC from 36%to71%1% for detection of severe immuno-suppression in our population, while retaining acceptable specificity (mean 68%) and PPV (mean 63%).
Routine immuno-suppression included an initial, intraoperative, induction dose of prednisolone, followed by CNI-based immunosuppression with cyclosporine A or tacrolimus with MMF or prednisolone.
The reasons for the breakdown of subretinal immuno-suppression and accumulation of MPs in AMD remain unknown.
They are neither specific nor sensitive for some infection cases, mainly in immuno-suppression patients.
