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This study investigates the immune condition in sepsis by analyzing the quantitative relationships among white blood cells, lymphocytes, and neutrophils in sepsis patients and healthy controls using data visualization analysis and three-dimensional numerical fitting to establish a mathematical model.
In sepsis, understanding the interplay among white blood cells, lymphocytes, and neutrophils is crucial for assessing the immune condition and optimizing treatment strategies. Blood samples were collected from 512 patients diagnosed with sepsis and 205 healthy controls, totaling 717 samples. Data visualization analysis and three-dimensional numerical fitting were performed to establish a mathematical model describing the relationships among white blood cells, lymphocytes, and neutrophils. Self-organizing feature map (SOFM) was employed to automatically cluster the sepsis sample data in the three-dimensional space represented by the model, yielding different immune states.
Analysis revealed that white blood cell, lymphocyte, and neutrophil counts are constrained within a three-dimensional plane, as described by the equation: WBC = 1.098 × Neutrophils + 1.046 × Lymphocytes + 0.1645, yielding a prediction error (RMSE) of 1%. This equation is universally applicable to all samples despite differences in their spatial distributions. SOFM clustering identified nine distinct immune states within the sepsis patient population, representing different levels of immune status, oscillation periods, and recovery stages.
The proposed mathematical model, represented by the equation above, reveals a basic constraint boundary on the immune cell populations in both sepsis patients and healthy controls. Furthermore, the SOFM clustering approach provides a comprehensive overview of the distinct immune states observed within this constraint boundary in sepsis patients. This study lays the foundation for future work on quantifying and categorizing the immune condition in sepsis, which may ultimately contribute to the development of more objective diagnostic and treatment strategies.
Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, remains a significant challenge in critical care medicine1. Despite advances in understanding the pathophysiology of sepsis, the complex interplay between the immune system and pathogens continues to pose difficulties in diagnosing and treating this condition effectively2. Current clinical approaches often focus on monitoring infection indicators, organ function, cytokines, microbial detection, and gut microbiome3. However, there is a growing recognition of the crucial role played by immune cells, particularly white blood cells, lymphocytes, and neutrophils, in the progression and resolution of sepsis4.
During the course of sepsis, the immune system undergoes a complex series of changes, characterized by an initial hyperinflammatory phase followed by a prolonged immunosuppressive phase5. The early phase is marked by a surge in neutrophil counts and a concomitant decrease in lymphocyte populations, reflecting the activation of innate immune responses and the suppression of adaptive immunity6. As the condition progresses, neutrophil levels may oscillate or become exhausted while lymphocyte counts continue to decline, leading to a state of immunosuppression that renders patients vulnerable to secondary infections7. Understanding the dynamic interplay among these immune cell populations is crucial for accurately assessing the immune status of sepsis patients and devising targeted interventions.
Traditional approaches to analyzing immune cell counts in sepsis have relied on univariate or bivariate analyses, which fail to capture the complex relationships among multiple immune parameters8. Recent advances in data visualization and machine learning techniques have opened up new possibilities for exploring high-dimensional immunological data9. In particular, three-dimensional scatter plot visualization and self-organizing feature maps (SOFM)10 have shown promise in uncovering hidden patterns and identifying distinct immune states in various disease contexts.
This study aims to investigate the immune condition in sepsis patients by analyzing the quantitative relationships among white blood cells, lymphocytes, and neutrophils using advanced data visualization and clustering techniques. The hypothesis is that these immune cell populations are constrained within a three-dimensional space governed by an underlying mathematical relationship. By uncovering this relationship and identifying distinct immune states using SOFM, the study seeks to provide a framework for understanding the immune dynamic states in sepsis and facilitating clinical decision-making.
The approach involves collecting blood samples from 512 sepsis patients admitted to the intensive care unit (ICU) and 205 healthy individuals, totaling 717 samples. The study population included both male (54.3%) and female (45.7%) participants, with ages ranging from 35 to 100 years (mean age: 73.5 years). Three-dimensional scatter plot visualization and numerical fitting are applied to establish a mathematical model describing the interplay among white blood cells, lymphocytes, and neutrophils in both sepsis patients and healthy controls. SOFM is then employed to automatically cluster the sepsis sample data in the three-dimensional space, yielding different immune states. By comparing the immune profiles and spatial distributions of sepsis patients with those of healthy individuals within the constraint boundary represented by the mathematical model, the study aims to gain insights into the pathophysiological mechanisms underlying sepsis and identify potential targets for immunomodulatory therapies.
By providing a quantitative method for assessing the immune condition of sepsis patients, the approach could enable more precise staging of the disease and guide the selection of appropriate interventions. Furthermore, the identification of distinct immune states using SOFM may lay the foundation for future research on personalized immunotherapy approaches tailored to the specific immune profiles of individual patients.
In summary, this study presents an approach to understanding the immune condition in sepsis by leveraging advanced data visualization and machine learning techniques. By uncovering the mathematical relationship between key immune cell populations in sepsis patients and healthy controls and identifying distinct immune states in sepsis patients, the study provides a new perspective on the complex immune dynamics in sepsis. This approach enables a more precise assessment of the disease state (Different Clusters) and can guide the selection of appropriate interventions, ultimately contributing to developing more effective diagnostic and therapeutic strategies.
This study explores the immune condition in sepsis patients by investigating the relationships among white blood cells, lymphocytes, and neutrophils. The patients were enrolled in the intensive care unit (ICU) of Dongzhimen Hospital in Beijing, China, and underwent standard blood tests after providing informed consent. The study was conducted as per the guidelines of the institutional human research ethics committee. Data grouping and detailed data content can be found in Supplementary Table 1. The software tools utilized in this study are enumerated in the Table of Materials.
1. Data collection and preparation
NOTE: White blood cells, neutrophils, and lymphocytes were selected as key indicators of the immune condition in sepsis patients. This choice is based on the well-established clinical observations that lymphocyte counts tend to be suppressed and gradually decrease, while neutrophil counts often oscillate in sepsis patients. These two cell types have been empirically recognized as important markers of the immune status in sepsis patient populations. However, the precise quantitative relationship among these parameters has not been clearly reported in the literature. Therefore, white blood cells, neutrophils, and lymphocytes were chosen as a starting point for quantifying the immune condition in sepsis patients.
2. Three-dimensional visualization of white blood cells, lymphocytes, and neutrophils
3. The formula
4. Immune condition in sepsis
NOTE: Self-Organizing Feature Maps (SOFM) were employed for unsupervised clustering to identify immune conditions in sepsis patients.
5. Typical immune oscillation trajectories in sepsis
The progression of sepsis involves a complex interplay between the human immune system and invading pathogens. In clinical diagnosis and treatment, much attention is focused on infection indicators, organ function markers, cytokines, microbial detection, and even the gut microbiome. However, this study emphasizes the importance of three common immune indicators: white blood cells, neutrophils, and lymphocytes, which are not without basis. Research has demonstrated that the pathological pr...
This study presents an approach to understanding the immune condition in sepsis by leveraging advanced data visualization and machine learning techniques. By uncovering the mathematical relationship among key immune cell populations and identifying distinct immune states, the study provides a new perspective on the complex immune dynamics in sepsis and contributes to the development of more effective diagnostic and therapeutic strategies11,12. The key findings in...
The software tool for Probabilistic Scatter Plots for Immune States V1.0 is developed and owned by Beijing Intelligent Entropy Science & Technology Co., Ltd. All intellectual property rights of this software are held by the company. The authors declare no conflicts of interest.
This study received support from two sources: the seventh batch of the Master-Apprentice Inheritance Project organized by the National Administration of Traditional Chinese Medicine of China (Project number: [2021] No. 272) and the 2024 Chinese Medicine Research Capacity Enhancement Project of Municipal-level Chinese Medicine Hospital (SZY-NLTL-2024-003) from the Shaanxi Provincial Administration of Traditional Chinese Medicine.
Name | Company | Catalog Number | Comments |
MATLAB | MathWorks | 2022B | Computing and visualization |
Probabilistic Scatter Plots for Immune States | Intelligent Entropy | Immune States V1.0 | Beijing Intelligent Entropy Science & Technology Co Ltd. Modeling for CT/MRI fusion |
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