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Fu D, Gao S, Li JN, Cui YH, Luo YW, Zhong YJ, Li Q, Luo C, Dai RP, Luo RY, Hu ZL. P75 NTR+CD64 + neutrophils promote sepsis-induced acute lung injury. Clin Immunol 2024; 263:110206. [PMID: 38599263 DOI: 10.1016/j.clim.2024.110206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/24/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
Patients suffering from sepsis-induced acute lung injury (ALI) exhibit a high mortality rate, and their prognosis is closely associated with infiltration of neutrophils into the lungs. In this study, we found a significant elevation of CD64+ neutrophils, which highly expressed p75 neurotrophin receptor (p75NTR) in peripheral blood of mice and patients with sepsis-induced ALI. p75NTR+CD64+ neutrophils were also abundantly expressed in the lung of ALI mice induced by lipopolysaccharide. Conditional knock-out of the myeloid lineage's p75NTR gene improved the survival rates, attenuated lung tissue inflammation, reduced neutrophil infiltration and enhanced the phagocytic functions of CD64+ neutrophils. In vitro, p75NTR+CD64+ neutrophils exhibited an upregulation and compromised phagocytic activity in blood samples of ALI patients. Blocking p75NTR activity by soluble p75NTR extracellular domain peptide (p75ECD-Fc) boosted CD64+ neutrophils phagocytic activity and reduced inflammatory cytokine production via regulation of the NF-κB activity. The findings strongly indicate that p75NTR+CD64+ neutrophils are a novel pathogenic neutrophil subpopulation promoting sepsis-induced ALI.
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Affiliation(s)
- Di Fu
- Department of Anesthesiology, The Xiangya Hospital, Central South University, Changsha City, Hunan 410008, China
| | - Shan Gao
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Jia-Nan Li
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Yan-Hui Cui
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha City, Hunan 410011, China
| | - Yan-Wei Luo
- Department of Blood Transfusion, The Third Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Yan-Jun Zhong
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiao Li
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Cong Luo
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Ru-Ping Dai
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Ru-Yi Luo
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China.
| | - Zhao-Lan Hu
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China.
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Huang X, Wu L, Ouyang Q, Huang Y, Hong L, Liu S, Yang K, Ning D, Tan CC. Neutrophil CD64 index as a new early predictive biomarker for infected pancreatic necrosis in acute pancreatitis. J Transl Med 2024; 22:218. [PMID: 38424643 PMCID: PMC10905911 DOI: 10.1186/s12967-024-04901-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/14/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Infectious pancreatic necrosis (IPN) is a serious complication of acute pancreatitis, and early recognition and timely intervention are the keys to improving clinical outcomes. The purpose of this study was to investigate the predictive capacity of the neutrophil CD64 index (nCD64 index) on IPN in patients with acute pancreatitis METHODS: This study comprises two independent cohorts: the training cohort consisted of 202 patients from Hunan Provincial People's Hospital, and the validation cohort consisted of 100 patients from Changsha Central Hospital. Peripheral blood samples were collected on the day of admission and on the 3rd, 5th, 7th, and 10th days of hospitalization, and the nCD64 index was detected by flow cytometry. Additionally, relevant clinical characteristics and laboratory biomarkers were collected and analyzed. RESULTS We observed that nCD64 index on admission was significantly higher in the IPN group than Non-IPN group (p < 0.001). In the training cohort, a higher occurrence rate of IPN was observed in the high nCD64 index group compared to the moderate and low nCD64 index group (p < 0.001). Further analysis showed that nCD64 index was significant positive correlated with the incidence rate of IPN (p < 0.001, correlation coefficient = 0.972). Furthermore, logistic regression analysis showed that high expression of the nCD64 index on admission was a risk factor for the occurrence of IPN (OR = 2.971, p = 0.038). We further found that the nCD64 index of IPN patients was significantly higher than the Non-IPN patients on the days 1, 3, and 5 after admission, and the nCD64 index of IPN patients before and after the onset (p < 0.05). At the same time, this study revealed that the nCD64 index on admission showed good predictive efficacy for IPN (AUC = 0.859, sensitivity = 80.8%, specificity = 87.5%), which was comparable to APACHE II score. And this finding was further validated in an independent cohort of 100 participants (AUC = 0.919, Sensitivity = 100.0%, Specificity = 76.6%). CONCLUSION This study demonstrated the clinical value of nCD64 index in patients with IPN patients for the first time through two independent cohort studies. The nCD64 index can be used as an early prediction and risk assessment tool for the occurrence of IPN, contributing to the improvement of patient outcomes and efficiency of medical resource allocation.
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Affiliation(s)
- Xiangping Huang
- Department of Clinical Laboratory, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), 61 Jiefang Road, Changsha, 410005, Hunan, People's Republic of China
| | - Ling Wu
- Department of Clinical Laboratory, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), 61 Jiefang Road, Changsha, 410005, Hunan, People's Republic of China
| | - Qianhui Ouyang
- Department of Clinical Laboratory, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), 61 Jiefang Road, Changsha, 410005, Hunan, People's Republic of China
| | - Ying Huang
- Department of Emergency, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China
| | - Lanhui Hong
- Department of Clinical Laboratory, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), 61 Jiefang Road, Changsha, 410005, Hunan, People's Republic of China
| | - Sixiang Liu
- Department of Emergency, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China
| | - Kongzhi Yang
- Department of Emergency Medical, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China
| | - Ding Ning
- Department of Emergency Medical, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China
| | - Chao Chao Tan
- Tumor Immunity Research Center of Hunan Provincial Geriatric Institute (Hunan Provincial People's Hospital), Changsha, Hunan, China.
- Department of Clinical Laboratory, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
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Xu F, Li Y, Wang X, Sun R, Zheng Z, Zhang Q, Gao M, Tao W, Zhao J, Wang Q. Effect of pre-infusion of hypertonic saline on postoperative delirium in geriatric patients undergoing shoulder arthroscopy: a randomized controlled trial. BMC Anesthesiol 2023; 23:405. [PMID: 38082215 PMCID: PMC10712129 DOI: 10.1186/s12871-023-02340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Neuroinflammation may be a potential mechanism of postoperative delirium (POD) in geriatric patients, and hypertonic saline (HS) has immunomodulatory properties. The purpose of this study was to investigate whether HS could reduce the incidence of POD in elderly patients and its effect on neutrophil activation and inflammatory cytokine expression. METHODS We studied the effect of pre-infusion of 4 mL/kg 3% hypertonic saline vs. 4 mL/kg 0.9% normal saline on POD in patients undergoing shoulder arthroscopy in a prospective, randomized, double-blind, controlled trial. Neutrophil surface molecules (CD11b, CD66b and CD64) were analyzed by flow cytometry. Circulating concentrations of inflammatory factors IL-1β, IL-6, TNF-α and neurological damage factor S100β were assessed by enzyme immunoassay. The Confusion Assessment Method-Chinese Revision (CAM-CR) was applied for the assessment of POD 1-3 days after surgery. RESULTS The incidence of POD in group H was significantly lower than that in group N (7.14% vs 26.83%, P = 0.036). The expression levels of inflammatory cytokines ( IL-6 and TNF-α) and neutrophil surface markers (CD11b and CD66b) were significantly lower in group H than in group N at 24 h after surgery (P = 0.018, P < 0.001, P < 0.001, P = 0.024). There were no significant differences in postoperative pain, nausea and vomiting, infection, phlebitis, and patients satisfaction between the two groups. CONCLUSION Pre-infusion of HS can reduce the incidence of POD and the immune-inflammatory response. TRIAL REGISTRATION Chinese Clinical Trial Registry (14/4/2022, registration number: ChiCTR2200058681.
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Affiliation(s)
- Fang Xu
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yanan Li
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xupeng Wang
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ran Sun
- Department of Joint Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zilei Zheng
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Anesthesiology, Zhangjiakou Fourth Hospital, Zhangjiakou, Hebei, China
| | - Qi Zhang
- Department of Anesthesiology, Children's Hospital of Hebei Province Affiliated to Hebei Medical University, Shijiazhuang, China
| | - Mingyang Gao
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Wei Tao
- Department of Breast Surgery, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Juan Zhao
- Teaching Experiment Center, Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Qiujun Wang
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
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Cui S, Qian J. Future Biomarkers for Infection and Inflammation in Rheumatoid Arthritis. J Inflamm Res 2023; 16:2719-2726. [PMID: 37404716 PMCID: PMC10317533 DOI: 10.2147/jir.s413579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Rheumatoid arthritis (RA) increases the susceptibility to a variety of infections that are often difficult to diagnose and can be asymptomatic or symptoms are atypical. Usually, this is a great challenge for rheumatologists, because it is difficult to distinguish infection and aseptic inflammation at an early stage. Prompt diagnosis and treatment of bacterial infections in immunosuppressed individuals is critical for clinicians, and early exclusion of infection allows for specific treatment of inflammatory diseases and avoids the unnecessary use of antibiotics. However, for patients with clinically suspected infection, traditional laboratory markers are not specific for bacterial infection and cannot be used to distinguish outbreaks from infections. Therefore, new infection markers that can distinguish infection from underlying disease are urgently needed for clinical practice. Here, we review the novel biomarkers in RA patients with infection. These biomarkers include presepsin, serology and haematology, as well as neutrophils, T cells, and natural killer cells. Meanwhile, we discuss meaningful biomarkers that distinguish infection from inflammation and develop novel biomarkers for clinical applications, allowing clinicians to make better decisions when diagnosing and treating RA.
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Affiliation(s)
- Shuang Cui
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China
| | - Jie Qian
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China
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