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Tang Y, Shen L, Yang D, Zhang J, Xie Q, Sun F, Luo Q. Neutrophil CD64 index as a potential blood biomarker for the diagnosis of neurosyphilis in secondary and tertiary syphilis: A retrospective study. Heliyon 2024; 10:e29027. [PMID: 38596103 PMCID: PMC11002674 DOI: 10.1016/j.heliyon.2024.e29027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Objective To examine the correlation of neutrophil CD64 (nCD64) index with neurosyphilis (NS) across different stages of syphilis. Methods A total of 1243 syphilis patients at different stages (344 of primary, 385 of secondary, and 514 of tertiary) included in this study were divided into NS and non-NS (NNS). Correlations of nCD64 index with currently used syphilis biomarkers were explored using Spearman correlation test. Relationships between nCD64 index and NS at different stages were investigated by stratified analysis and restricted cubic spline model. The diagnostic performance of nCD64 index for NS was assessed by receiver operating characteristic (ROC) curve. Results Significant statistical correlations of nCD64 index with cerebrospinal fluid (CSF) NS indicators were found in secondary and tertiary syphilis. Increased nCD64 index was associated with increased risk of NS in secondary and tertiary syphilis. ROC analysis values further confirmed the diagnostic potential of nCD64 index for NS. Marked decrease of nCD64 index was observed in NS patients after effective antisyphilitic treatments. Conclusions The nCD64 index may help to the diagnosis of NS in secondary and tertiary syphilis.
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Affiliation(s)
- Yijie Tang
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lingyun Shen
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Dandan Yang
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiaqin Zhang
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qinghui Xie
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fenyong Sun
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qingqiong Luo
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
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Dong J, Duan RS, Zhang P. Causal relationship between the immune phenotype of monocytes and myasthenia gravis: A Mendelian randomization study. Heliyon 2024; 10:e26741. [PMID: 38449651 PMCID: PMC10915380 DOI: 10.1016/j.heliyon.2024.e26741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/30/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024] Open
Abstract
Background Monocytes play an essential role in developing autoimmune diseases; however, their association with myasthenia gravis (MG) development is unclear. Methods We performed a two-sample Mendelian randomization analysis to assess the causal relationship between monocyte-associated traits and MG, reviewing summary statistics of genome-wide association studies (GWAS). Results Using the inverse variance weighted method, the following were found to be causally associated with MG: HLA-DR on monocytes (OR, 1.363; 95% CI, 1.158-1.605; P = 2E-04), HLA-DR on CD14+ monocytes (OR, 1.324; 95% CI, 1.183-1.482; P = 1.08E-06), HLA-DR on CD14+CD16- monocytes (OR, 1.313; 95% CI, 1.177-1.465; P = 1.07E-06), CD40 on monocytes (OR, 1.135; 95% CI, 1.012-1.272; P < 0.05), CD40 on CD14+CD16- monocytes (OR, 1.142; 95% CI, 1.015-1.285; P < 0.05), CD40 on CD14+CD16+ monocytes (OR, 1.142; 95% CI, 1.021-1.278; P < 0.05), CD64 on CD14+CD16+ monocytes (OR, 1.286; 95% CI, 1.019-1.623; P < 0.05). Conclusions The present study suggests a causal relationship between the upregulation of CD40, HLA-DR, and CD64 on monocytes and the development of MG. Altered monocyte function may potentially be a risk factor for MG and a therapeutic target.
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Affiliation(s)
- Jing Dong
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
| | - Rui-sheng Duan
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
- Shandong Institute of Neuroimmunology, Jinan, Shandong Province, China
- Shandong Provincial Medicine and Health Key Laboratory of Neuroimmunology, Shandong Province, China
- Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Jinan, Shandong Province, China
| | - Peng Zhang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
- Shandong Institute of Neuroimmunology, Jinan, Shandong Province, China
- Shandong Provincial Medicine and Health Key Laboratory of Neuroimmunology, Shandong Province, China
- Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Jinan, Shandong Province, China
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Suri TM, Hadda V, Ali S, Chopra A, Khan MA, Singh J, Ghosh T, Mittal S, Tiwari P, Madan K, Mohan A, Guleria R. Association of Leukocyte Subpopulations Identified by Flow Cytometry with Outcomes of Sepsis in a Respiratory Intensive Care Unit: An Observational Study. J Intensive Care Med 2024; 39:125-135. [PMID: 37554063 PMCID: PMC7615840 DOI: 10.1177/08850666231193962] [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] [Indexed: 08/10/2023]
Abstract
INTRODUCTION The dysregulated host immune response in sepsis is orchestrated by peripheral blood leukocytes. This study explored the associations of the peripheral blood leukocyte subpopulations with early clinical deterioration and mortality in sepsis. METHODS We performed a prospective observational single-center study enrolling adult subjects with sepsis within 48 h of hospital admission. Peripheral blood flow cytometry was performed for the patients at enrolment and after 5 days. The primary outcome was to explore the association between various leukocyte subpopulations at enrolment and early clinical deterioration [defined as an increase in the sequential organ failure assessment (SOFA) score between enrolment and day 5, or death before day 5]. Other pre-specified outcomes explored associations of leukocyte subpopulations at enrolment and on day 5 with in-hospital mortality. RESULTS A total of 100 patients, including 47 with septic shock were enrolled. The mean (SD) age of the patients was 53.99 (14.93) years. Among them, 26 patients had early clinical deterioration, whereas 41 died during hospitalization. There was no significant association between the leukocyte subpopulations at enrolment and early clinical deterioration on day 5. On multivariate logistic regression, a reduced percentage of CD8 + CD25+ T-cells at enrolment was associated with in-hospital mortality [odds ratio (OR), 0.82 (0.70-0.97); p-value = 0.02]. A reduced lymphocyte percentage on day 5 was associated with in-hospital mortality [OR, 0.28 (0.11-0.69); p-value = 0.01]. In a post-hoc analysis, patients with "very early" deterioration within 48 h had an increased granulocyte CD64 median fluorescent intensity (MFI) [OR, 1.07 (1.01-1.14); p-value = 0.02] and a reduced granulocyte CD16 MFI [OR, 0.97 (0.95-1.00); p-value = 0.04] at enrolment. CONCLUSIONS None of the leukocyte subpopulations showed an association with early clinical deterioration at day 5. Impaired lymphocyte activation and lymphocytopenia indicative of adaptive immune dysfunction may be associated with in-hospital mortality.
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Affiliation(s)
- Tejas Menon Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Hadda
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shadab Ali
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof Ahmad Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Jay Singh
- Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Tamoghna Ghosh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pawan Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Chen X, Johansson U, Cherian S. Flow Cytometric Assessment of Myelodysplastic Syndromes/Neoplasms. Clin Lab Med 2023; 43:521-547. [PMID: 37865501 DOI: 10.1016/j.cll.2023.06.006] [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] [Indexed: 10/23/2023]
Abstract
Myelodysplastic syndromes/neoplasms (MDS) are a heterogeneous class of hematopoietic stem cell neoplasms characterized by ineffective hematopoiesis leading to peripheral cytopenias. This group of diseases is typically diagnosed using a combination of clinical, morphologic, and genetic criteria. Many studies have described the value of multiparametric flow cytometry (MFC) in the diagnosis, classification, and prognostication of MDS. This review summarizes the approach to MDS diagnosis and immunophenotypic characterization using MFC and describes the current state while highlighting future opportunities and potential pitfalls.
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Affiliation(s)
- Xueyan Chen
- Translational Science and Therapeutics Division, Fred Hutch Cancer Center, Seattle, WA, USA; Department of Laboratory Medicine and Pathology, University of Washington, 825 Eastlake Avenue East, Seattle, WA 98109, USA
| | - Ulrika Johansson
- SI-HMDS, Haematology, UHBW NHS Foundation Trust, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Sindhu Cherian
- Department of Laboratory Medicine and Pathology, University of Washington, 825 Eastlake Avenue East, Seattle, WA 98109, USA.
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Pham HM, Nguyen DLM, Duong MC, Phan XT, Tran LT, Trang DHT, Pham TTN. Neutrophil CD64-a prognostic marker of sepsis in intensive care unit: a prospective cohort study. Front Med (Lausanne) 2023; 10:1251221. [PMID: 37746077 PMCID: PMC10514672 DOI: 10.3389/fmed.2023.1251221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Background Little is known about the prognostic ability of nCD64 in critically ill patients. This study aimed to assess the prognostic values of nCD64 in adult ICU patients with sepsis. Methods A prospective cohort study was conducted at the ICU of Cho Ray Hospital in Vietnam between January 2019 to September 2020. All newly admitted 86 septic patients diagnosed based on sepsis-3 criteria were included. An evaluation of nCD64 was performed at admission (T0) and 48 h thereafter (T48). Delta nCD64 (nCD64 T48 - nCD64 T0), %delta nCD64 [(nCD64 T48 - nCD64 T0)/nCD64 T0 x 100%], APACHE II and SOFA scores were calculated and examined. Serum procalcitonin levels and white blood cell counts were documented. Spearman's rank correlation coefficient was used to test the correlation between nCD64 and severity scores. Receiver-operating characteristic (ROC) curve was performed to evaluate the predictive efficacy of the sepsis parameters. Results Patients with septic shock had significantly higher nCD64 levels than septic patients [3,568 (2,589; 5,999) vs. 1,514 (1,416;2,542) molecules/cell, p < 0.001]. nCD64 T0 and SOFA scores had a moderately positive linear correlation (R = 0.31, p = 0.004). In the survivor group, nCD64 levels significantly decreased within the first 48 h of admission (p < 0.001), while this trend was not statistically significant in the non-survivor group (p = 0.866). The area under the ROC curve (AUC) value of %delta nCD64 combined with APACHE II score (0.81) was higher than that of any other parameter alone or in combination with each other. Conclusion The nCD64 index may serve as a valuable biomarker for predicting the course of sepsis. Monitoring changes in nCD64 during the initial 48 h of admission can aid in predicting the prognosis of septic patients. The use of a combination of the trends of nCD64 index in the first 48 h with APACHE II score would further enhance the predictive accuracy. More studies with longer follow-ups are needed to fully understand the implications of serial trend and kinetics of nCD64 in septic patients.
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Affiliation(s)
- Huy Minh Pham
- Department of Emergency and Critical Care, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Intensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | | | - Minh Cuong Duong
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Xuan Thi Phan
- Intensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Linh Thanh Tran
- Intensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | | | - Thao Thi Ngoc Pham
- Department of Emergency and Critical Care, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Intensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, Vietnam
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Le Joncour A, Régnier P, Maciejewski-Duval A, Charles E, Barete S, Fouret P, Rosenzwajg M, Klatzmann D, Cacoub P, Saadoun D. Reduction of Neutrophil Activation by Phosphodiesterase 4 Blockade in Behçet's Disease. Arthritis Rheumatol 2023; 75:1628-1637. [PMID: 36862398 DOI: 10.1002/art.42486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/17/2023] [Accepted: 02/15/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Behçet's disease (BD) is a systemic vasculitis with inflammatory lesions mediated by cytotoxic T cells and neutrophils. Apremilast, an orally available small-molecule drug that selectively inhibits phosphodiesterase 4 (PDE4), has been recently approved for the treatment of BD. We aimed to investigate the effect of PDE4 inhibition on neutrophil activation in BD. METHODS We studied surface markers and reactive oxygen species (ROS) production by flow cytometry, and neutrophil extracellular traps (NETs) production and molecular signature of neutrophils by transcriptome analysis before and after PDE4 inhibition. RESULTS Activation surface markers (CD64, CD66b, CD11b, and CD11c), ROS production, and NETosis were up-regulated in BD patient neutrophils compared to healthy donor neutrophils. Transcriptome analysis revealed 1,021 significantly dysregulated neutrophil genes between BD patients and healthy donors. Among dysregulated genes, we found a substantial enrichment for pathways linked to innate immunity, intracellular signaling, and chemotaxis in BD. Skin lesions of BD patients showed increased infiltration of neutrophils that colocalized with PDE4. Inhibition of PDE4 by apremilast strongly inhibited neutrophil surface activation markers as well as ROS production, NETosis, and genes and pathways related to innate immunity, intracellular signaling, and chemotaxis. CONCLUSION We highlight key biologic effects of apremilast on neutrophils in BD.
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Affiliation(s)
- Alexandre Le Joncour
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France
| | - Paul Régnier
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Anna Maciejewski-Duval
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Erwan Charles
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphane Barete
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Unit of Dermatology, Paris, France
| | - Pierre Fouret
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Anatomopathology, Paris, France
| | - Michelle Rosenzwajg
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - David Klatzmann
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, and Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, France
| | - Patrice Cacoub
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France
| | - David Saadoun
- Sorbonne Université, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Laboratoire d'excellence TRANSIMMUNOM, Paris, and Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, Paris, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France
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Yang Y, Griffin K, Li X, Sharp E, Young L, Garcia L, Griswold J, Pappas D. Combined CD25, CD64, and CD69 Biomarker in 3D-Printed Multizone Millifluidic Device for Sepsis Detection in Clinical Samples. Anal Chem 2023; 95:12819-12825. [PMID: 37556314 DOI: 10.1021/acs.analchem.3c01797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Sepsis is a serious medical condition that arises from a runaway response to an infection, which triggers the immune system to release chemicals into the bloodstream. This immune response can result in widespread inflammation throughout the body, which may cause harm to vital organs and, in more severe cases, lead to organ failure and death. Timely and accurate diagnosis of sepsis remains a challenge in analytical diagnostics. In this work, we have developed and validated a sepsis detection device, utilizing 3D printing technology, which incorporates multiple affinity separation zones. Our device requires minimal operator intervention and utilizes CD64, CD69, and CD25 as the biomarker targets for detecting sepsis in liquid biopsies. We assessed the effectiveness of our 3D-printed multizone cell separation device by testing it on clinical samples obtained from both septic patients (n = 35) and healthy volunteers (n = 8) and validated its performance accordingly. Unlike previous devices using poly(dimethyl siloxane), the 3D-printed device had reduced nonspecific binding for anti-CD25 capture, allowing this biomarker to be assayed for the first time in cell separations. Our results showed a statistically significant difference in cell capture between septic and healthy samples (with p values of 0.0001 for CD64, CD69, and CD25), suggesting that 3D-printed multizone cell capture is a reliable method for distinguishing sepsis. A receiver operator characteristic (ROC) analysis was performed to determine the accuracy of the captured cell counts for each antigen in detecting sepsis. The ROC area under the curve (AUC) values for on-chip detection of CD64+, CD69+, and CD25+ leukocytes were 0.96, 0.92, and 0.88, respectively, indicating our diagnostic test matches clinical outcomes. When combined for sepsis diagnosis, the AUC value for CD64, CD69, and CD25 was 0.99, indicating an improved diagnostic performance due to the use of multiple biomarkers.
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Affiliation(s)
- Yijia Yang
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409, United States
| | - Kitiara Griffin
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409, United States
| | - Xiao Li
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409, United States
| | - Elizabeth Sharp
- Clinical Research Institute, Texas Tech Health Sciences Center, Lubbock, Texas 79409, United States
| | - Lane Young
- Clinical Research Institute, Texas Tech Health Sciences Center, Lubbock, Texas 79409, United States
| | - Liza Garcia
- Clinical Research Institute, Texas Tech Health Sciences Center, Lubbock, Texas 79409, United States
| | - John Griswold
- Department of Surgery, Texas Tech Health Sciences Center, Lubbock, Texas 79409, United States
| | - Dimitri Pappas
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409, United States
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Dinleyici EC, Frey G, Kola E, Wippermann U, Bauhofer A, Staus A, Griffiths P, Azharry M, Rohsiswatmo R. Clinical efficacy of IgM-enriched immunoglobulin as adjunctive therapy in neonatal and pediatric sepsis: a systematic review and meta-analysis. Front Pediatr 2023; 11:1239014. [PMID: 37635792 PMCID: PMC10451087 DOI: 10.3389/fped.2023.1239014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Background Sepsis is a major cause of mortality and morbidity globally, with around one-quarter of all sepsis-related deaths occurring in children under the age of 5. We conducted a meta-analysis and systematic review of the literature to evaluate the clinical effectiveness of an IgM-enriched immunoglobulin preparation in pediatrics patients and neonates with sepsis. Methods Systematic searches of PubMed, the Cochrane Library and Embase databases were performed in November 2022, with no date limitations, to identify studies in which IgM-enriched immunoglobulin was used as adjunctive therapy in neonatal and pediatric patients with sepsis. Results In total, 15 studies fulfilled the eligibility criteria, 13 neonatal studies and 2 pediatric studies. Pooled estimates from all studies indicated that mortality rates were significantly lower in patients who received treatment with the IgM-enriched immunoglobulin compared with controls (OR 0.41; 95% CI 0.32-0.55). Further analyses in neonatal studies, alone, showed a significant benefit with longer treatment durations (>3 days) vs. the recommended treatment duration (3 days) (OR 0.32; 95% CI 0.22-0.47) vs. (OR 0.61; 95% CI 0.41-0.92). Treatment with IgM-enriched immunoglobulin was associated with a lower mortality risk compared with controls in prospective studies vs. retrospective analyses (OR 0.37; 95% CI 0.27-0.51) vs. (OR 0.73; 95% CI 0.41-1.30). Conclusions This systematic review suggests that adjunctive treatment with IgM-enriched immunoglobulin may reduce the risk of mortality in neonatal and pediatric populations. However, large randomized controlled trials are required to further substantiate and evaluate these findings.
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Affiliation(s)
- Ener Cagri Dinleyici
- Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - Georg Frey
- Klinik für Neonatologie, Darmstädter Kinderkliniken Prinzessin Margaret, Perinatalzentrum Südhessen, Darmstadt, Germany
| | - Ermira Kola
- Pediatric Intensive Care Unit, University Hospital Center “Mother Teresa”, Tirana, Albania
| | | | - Artur Bauhofer
- Corporate Medical Affairs, Biotest AG, Dreieich, Germany
| | - Alexander Staus
- Corporate Clinical Research & Development, Biotest AG, Dreieich, Germany
| | - Peter Griffiths
- Medical and Scientific Affairs, Biotest UK, Birmingham, United Kingdom
| | - Muhamad Azharry
- Department of Child Health, Neonatology Division, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Rinawati Rohsiswatmo
- Department of Child Health, Neonatology Division, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
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Lee J, Son S, Kim H, Ju M. Delta Neutrophil Index as a New Early Mortality Predictor after Liver Transplantation. J Clin Med 2023; 12:jcm12072501. [PMID: 37048585 PMCID: PMC10095468 DOI: 10.3390/jcm12072501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/18/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Patients with liver disease display numerous defects of the immune system, so infection is a frequent complication of both acute and chronic liver disease. These infections are independently associated with poor outcomes after liver transplantation. Our objective was to evaluate the delta neutrophil index (DNI), a new inflammation marker, as a predictor of survival after liver transplantation (LT). Methods: This observational study retrospectively evaluated the records of 712 patients who underwent LT from January 2010 to February 2018. DNI was evaluated at pre-transplantation and 1, 7, 14, and 30 days after operation. Statistical analysis was performed using the T-test or chi-square test, and logistic regression analysis. Results: The mean MELD score was 16.7 ± 9.4 (0–48). There were 125 mortality cases (17.8%) after liver transplantation. Mean DNI was 1.61 at pre-transplantation, 3.94 one day after operation, 2.67 seven days after operation, 1.61 fourteen days after operation, and 1.64 thirty days after operation, respectively. In multivariate analysis, DNI seven and fourteen days after operation was revealed as an independent prognostic factor for mortality after liver transplantation (p = 0.040 and p < 0.0001). Conclusions: The DNI is a simple and reliable predictor of patient mortality after liver transplantation.
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Affiliation(s)
| | | | | | - Manki Ju
- Correspondence: ; Tel.: +82-2-2019-3893; Fax: +82-2-2019-4827
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van de Ven NLM, Bongers SH, Spijkerman R, Koenderman L, Leenen LPH, Hietbrink F. Point-of-care neutrophil CD64 as a rule in diagnostic test for bacterial infections in the emergency department. BMC Emerg Med 2023; 23:28. [PMID: 36915043 PMCID: PMC10010956 DOI: 10.1186/s12873-023-00800-2] [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: 05/31/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION Bacterial infections are frequently seen in the emergency department (ED), but can be difficult to distinguish from viral infections and some non-infectious diseases. Common biomarkers such as c-reactive protein (CRP) and white blood cell (WBC) counts fail to aid in the differential diagnosis. Neutrophil CD64 (nCD64), an IgG receptor, is suggested to be more specific for bacterial infections. This study investigated if nCD64 can distinguish bacterial infections from other infectious and non-infectious diseases in the ED. METHODS All COVID-19 suspected patients who visited the ED and for which a definitive diagnosis was made, were included. Blood was analyzed using an automated flow cytometer within 2 h after presentation. Patients were divided into a bacterial, viral, and non-infectious disease group. We determined the diagnostic value of nCD64 and compared this to those of CRP and WBC counts. RESULTS Of the 291 patients presented at the ED, 182 patients were included with a definitive diagnosis (bacterial infection n = 78; viral infection n = 64; non-infectious disease n = 40). ROC-curves were plotted, with AUCs of 0.71 [95%CI: 0.64-0.79], 0.77 [0.69-0.84] and 0.64 [0.55-0.73] for nCD64, WBC counts and CRP, respectively. In the bacterial group, nCD64 MFI was significantly higher compared to the other groups (p < 0.01). A cut-off of 9.4 AU MFI for nCD64 corresponded with a positive predictive value of 1.00 (sensitivity of 0.27, a specificity of 1.00, and an NPV of 0.64). Furthermore, a diagnostic algorithm was constructed which can serve as an example of what a future biomarker prediction model could look like. CONCLUSION For patients in the ED presenting with a suspected infection, nCD64 measured with automatic flow cytometry, has a high specificity and positive predictive value for diagnosing a bacterial infection. However, a low nCD64 cannot rule out a bacterial infection. For future purposes, nCD64 should be combined with additional tests to form an algorithm that adequately diagnoses infectious diseases.
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Affiliation(s)
- N L M van de Ven
- Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S H Bongers
- Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Spijkerman
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L Koenderman
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L P H Leenen
- Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Hietbrink
- Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
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11
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Atallah J, Ghebremichael M, Timmer KD, Warren HM, Mallinger E, Wallace E, Strouts FR, Persing DH, Mansour MK. Novel Host Response-Based Diagnostics to Differentiate the Etiology of Fever in Patients Presenting to the Emergency Department. Diagnostics (Basel) 2023; 13:953. [PMID: 36900096 PMCID: PMC10000761 DOI: 10.3390/diagnostics13050953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Fever is a common presentation to urgent-care services and is linked to multiple disease processes. To rapidly determine the etiology of fever, improved diagnostic modalities are necessary. This prospective study of 100 hospitalized febrile patients included both positive (FP) and negative (FN) subjects in terms of infection status and 22 healthy controls (HC). We evaluated the performance of a novel PCR-based assay measuring five host mRNA transcripts directly from whole blood to differentiate infectious versus non-infectious febrile syndromes as compared to traditional pathogen-based microbiology results. The FP and FN groups observed a robust network structure with a significant correlation between the five genes. There were statistically significant associations between positive infection status and four of the five genes: IRF-9 (OR = 1.750, 95% CI = 1.16-2.638), ITGAM (OR = 1.533, 95% CI = 1.047-2.244), PSTPIP2 (OR = 2.191, 95% CI = 1.293-3.711), and RUNX1 (OR = 1.974, 95% CI = 1.069-3.646). We developed a classifier model to classify study participants based on these five genes and other variables of interest to assess the discriminatory power of the genes. The classifier model correctly classified more than 80% of the participants into their respective groups, i.e., FP or FN. The GeneXpert prototype holds promise for guiding rapid clinical decision-making, reducing healthcare costs, and improving outcomes in undifferentiated febrile patients presenting for urgent evaluation.
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Affiliation(s)
- Johnny Atallah
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Infectious Diseases Division, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Musie Ghebremichael
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02138, USA
| | - Kyle D. Timmer
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Infectious Diseases Division, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Hailey M. Warren
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Infectious Diseases Division, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ella Mallinger
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Infectious Diseases Division, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | | | | | - Michael K. Mansour
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Infectious Diseases Division, Massachusetts General Hospital, Boston, MA 02114, USA
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12
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Monitoring of the Forgotten Immune System during Critical Illness-A Narrative Review. Medicina (B Aires) 2022; 59:medicina59010061. [PMID: 36676685 PMCID: PMC9866378 DOI: 10.3390/medicina59010061] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/24/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022] Open
Abstract
Immune organ failure is frequent in critical illness independent of its cause and has been acknowledged for a long time. Most patients admitted to the ICU, whether featuring infection, trauma, or other tissue injury, have high levels of alarmins expression in tissues or systemically which then activate innate and adaptive responses. Although necessary, this response is frequently maladaptive and leads to organ dysfunction. In addition, the counter-response aiming to restore homeostasis and repair injury can also be detrimental and contribute to persistent chronic illness. Despite intensive research on this topic in the last 40 years, the immune system is not routinely monitored in critical care units. In this narrative review we will first discuss the inflammatory response after acute illness and the players of maladaptive response, focusing on neutrophils, monocytes, and T cells. We will then go through commonly used biomarkers, like C-reactive protein, procalcitonin and pancreatic stone protein (PSP) and what they monitor. Next, we will discuss the strengths and limitations of flow cytometry and related techniques as an essential tool for more in-depth immune monitoring and end with a presentation of the most promising cell associated markers, namely HLA-DR expression on monocytes, neutrophil expression of CD64 and PD-1 expression on T cells. In sum, immune monitoring critically ill patients is a forgotten and missing piece in the monitoring capacity of intensive care units. New technology, including bed-side equipment and in deep cell phenotyping using emerging multiplexing techniques will likely allow the definition of endotypes and a more personalized care in the future.
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13
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Gao Y, Lin L, Zhao J, Peng X, Li L. Neutrophil CD64 index as a superior indicator for diagnosing, monitoring bacterial infection, and evaluating antibiotic therapy: a case control study. BMC Infect Dis 2022; 22:892. [PMID: 36443747 PMCID: PMC9703738 DOI: 10.1186/s12879-022-07725-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Neutrophil CD64 (nCD64) index has been widely studied as an indication of bacteria-infected diseases, but the exact usage of nCD64 index in monitoring infections remains debated. So this study aims to investigate the functionality of nCD64 index in tracking infections' progression and evaluating antibiotic therapy. METHODS 160 participants (36 healthy controls, 34 culture-negative patients, 56 respiratory tract infected patients, and 34 bloodstream infected patients) were recruited and divided into groups. Data on nCD64 index, T lymphocyte subsets, and conventional indicators, including white blood cell count, neutrophil to lymphocyte ratio, procalcitonin, and C-reactive protein, were tested and compared. RESULTS Bacteria-infected patients had significantly higher nCD64 indexes (p < 0.05), especially patients with both bloodstream and respiratory tract infections. The nCD64 index could identify infected patients from culture-negative patients or controls, which conventional indicators cannot achieve. We followed up with 24 infected patients and found that their nCD64 indexes were promptly down-regulated after effective antibiotic therapy (3.16 ± 3.01 vs. 1.20 ± 1.47, p < 0.001). CONCLUSION The nCD64 index is a sensitive indicator for clinical diagnosis of bacterial infection, especially in monitoring infection and evaluating antibiotics' efficacy. Therefore, nCD64 has the potential to improve diagnostic accuracy and provide rapid feedback on monitoring disease progression in infected patients.
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Affiliation(s)
- Yanting Gao
- grid.412478.c0000 0004 1760 4628Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China
| | - Lihui Lin
- grid.412478.c0000 0004 1760 4628Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China
| | - Jinyan Zhao
- grid.412478.c0000 0004 1760 4628Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China
| | - Xia Peng
- grid.412478.c0000 0004 1760 4628Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China
| | - Li Li
- grid.412478.c0000 0004 1760 4628Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University, 85 Wujin Road, 200080 Shanghai, China
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14
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Verma P, Singh A, Kushwaha R, Yadav G, Verma SP, Singh US, Reddy HD, Agarwal A. Early and Effective Diagnosis of Sepsis Using Flow Cytometry. J Lab Physicians 2022. [DOI: 10.1055/s-0042-1757722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Objective Sepsis is a major global health issue due to its high death and morbidity rates. To avoid the negative effects of sepsis and decrease mortality, it is vital to diagnose and treat it as soon as possible. Blood cultures can take up to 2 days to give result, and they are not always reliable. According to recent studies, neutrophil CD64 expression might be a sensitive and specific option for assessing sepsis. This study aimed to evaluate the diagnostic performance of a flow cytometry analysis for the expression of neutrophil CD64 in sepsis and its comparison with other standard tests in a tertiary care center.
Materials and Methods Prospective analysis on 40 blood samples from suspected sepsis patients admitted to intensive care units with criteria for the systemic inflammatory response syndrome on presentation was performed for expression of neutrophil CD64, C-reactive protein, procalcitonin, and complete blood count. Ten healthy volunteers were also enrolled in this prospective study. The laboratory results were compared in different groups.
Results The neutrophil CD64 had the highest diagnostic value to differentiate between patients of sepsis and nonsepsis groups with a sensitivity of 100% (95% confidence interval [CI]: 77.19–100%) and 100% (95% CI: 55.32–86.83%); specificity of 90.00% (95% CI: 59.58–99.49%) and 87.24% (95% CI: 66.69–99.61%); and likelihood ratio of 10.00 and 7.84, respectively.
Conclusion The neutrophil CD64 expression provides a more sensitive, specific, and novel marker for the early detection of sepsis in critically ill patients.
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Affiliation(s)
- Pratima Verma
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anurag Singh
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rashmi Kushwaha
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Geeta Yadav
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shailendra P. Verma
- Department of Clinical Hematology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Uma S. Singh
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Himanshu D. Reddy
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Avinash Agarwal
- Department of Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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15
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Hong Y, Chen L, Sun J, Xing L, Yang Y, Jin X, Cai H, Dong L, Zhou L, Zhang Z. Single-cell transcriptome profiling reveals heterogeneous neutrophils with prognostic values in sepsis. iScience 2022; 25:105301. [PMID: 36304125 PMCID: PMC9593767 DOI: 10.1016/j.isci.2022.105301] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/16/2022] [Accepted: 09/29/2022] [Indexed: 11/20/2022] Open
Abstract
Neutrophils constitute the largest proportion of nucleated peripheral blood cells, and neutrophils have substantial heterogeneity. We profiled nearly 300,000 human peripheral blood cells in this study using single-cell RNA sequencing. A large proportion (>50%) of these cells were annotated as neutrophils. Neutrophils were further clustered into four subtypes, including Neu1, Neu2, Neu3, and Neu4. Neu1 is characterized by high expression of MMP9, HP, and RGL4. Neu1 was associated with septic shock and significantly correlated with the sequential organ failure assessment (SOFA) score. A gene expression module in Neu1 named Neu1_C (characterized by expression of NFKBIA, CXCL8, G0S2, and FTH1) was highly predictive of septic shock with an area under the curve of 0.81. The results were extensively validated in external bulk datasets by using single-cell deconvolution methods. In summary, our study establishes a general framework for studying neutrophil-related mechanisms, prognostic biomarkers, and potential therapeutic targets for septic shock. Neutrophils were clustered into four subtypes, including Neu1, Neu2, Neu3, and Neu4 Neu1 was associated with septic shock Neu1 was correlated with the sequential organ failure assessment (SOFA) score A gene expression module in Neu1 named Neu1_C was highly predictive of septic shock
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Affiliation(s)
- Yucai Hong
- Department of Emergency Medicine, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Lin Chen
- Department of Critical Care Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Jian Sun
- Department of Critical Care Medicine, Lishui Center Hospital, Lishui, Zhejiang 323000, China
| | - Lifeng Xing
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Yi Yang
- Department of Emergency Medicine, The Second Hospital of Jiaxing, Jiaxing, 314000, P.R.China
| | - Xiaohong Jin
- Department of Emergency Medicine, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling 317500, Zhejiang Province, China
| | - Huabo Cai
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Lianlian Dong
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Liping Zhou
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Zhongheng Zhang
- Department of Emergency Medicine, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China,Key Laboratory of Digital Technology in Medical Diagnostics Of Zhejiang Province, Hangzhou, Zhejiang, China,Corresponding author
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16
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Wang B, Tang R, Wu S, Liu M, Kanwal F, Rehman MFU, Wu F, Zhu J. Clinical Value of Neutrophil CD64 Index, PCT, and CRP in Acute Pancreatitis Complicated with Abdominal Infection. Diagnostics (Basel) 2022; 12:diagnostics12102409. [PMID: 36292098 PMCID: PMC9600359 DOI: 10.3390/diagnostics12102409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 01/03/2023] Open
Abstract
Objective: To study the clinical diagnostic value of neutrophil CD64 index, PCT, and CRP in patients with acute pancreatitis with abdominal infection. Methods: A number of patients with acute pancreatitis (n = 234) participated in the study. According to the infection and health conditions, they were further divided into the non-infection group (n = 122), infection group (n = 78), and sepsis group (n = 34), and 40 healthy subjects were selected in the control group (n = 40). Expression levels of infection indexes, such as CD64 index, PCT, and CRP, were detected and compared. ROC curves were drawn to compare the efficacy of each index in the diagnosis of acute pancreatitis with abdominal infection and sepsis. The study was retrospectively registered under the China Clinical Trial Registry as a trial number ChiCTR2100054308. Results: All indexes were significantly higher in three clinical groups than the healthy control group (p < 0.05). The CD64 index, CD64 positive rate, and PCT in the infected group were significantly higher than those in the uninfected group (ALL p < 0.05). The PCT of patients infected with Gram-negative bacteria was significantly higher than that of Gram-positive bacteria-infected patients (p < 0.05). CD64 index had the best diagnostic efficiency for acute pancreatitis infection, with 82.14% sensitivity, 88.51% specificity, and 0.707 Youden indexes. The CD64 Youden index (0.780) for sepsis diagnosis was the highest, while the AUC of PCT was the highest (0.897). Conclusion: CD64 index combined with PCT has good sensitivity and specificity in diagnosing acute pancreatitis infection and sepsis.
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Affiliation(s)
- Biao Wang
- Department of Gastrointestinal Surgery, Renmin Hospital, Hubei University of Medicine, No. 39, Chaoyang Middle Road, Shiyan 442000, China
| | - Rongzhu Tang
- Department of Gastroenterology, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, No. 358, Datong Road, Pudong New District, Shanghai 200137, China
| | - Shaohong Wu
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ming Liu
- Department of Emergency, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fariha Kanwal
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Muhammad Fayyaz ur Rehman
- Institute of Chemistry, University of Sargodha, Sargodha 40100, Pakistan
- Correspondence: (M.F.u.R.); (F.W.); (J.Z.)
| | - Fang Wu
- Department of Gynecology, Obstetrics and Gynae Hospital, Fudan University, Shanghai 200437, China
- Correspondence: (M.F.u.R.); (F.W.); (J.Z.)
| | - Jianping Zhu
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (M.F.u.R.); (F.W.); (J.Z.)
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17
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Béres-Molnár KA, Czeti Á, Takács F, Barna G, Kis D, Róka G, Folyovich A, Toldi G. Successful thrombolytic therapy is associated with increased granulocyte CD15 expression and reduced stroke-induced immunosuppression. Brain Behav 2022; 12:e2732. [PMID: 36111748 PMCID: PMC9575610 DOI: 10.1002/brb3.2732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/16/2022] [Accepted: 07/13/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Stroke-induced immunosuppression (SIIS) increases the risk of poststroke infections. We aimed to determine whether failed versus successful thrombolytic therapy (TT) resulted in SIIS-associated changes in peripheral granulocyte markers at 1 week following the insult. METHODS We collected peripheral blood samples from 19 patients with acute ischemic stroke undergoing TT within 6 h after the onset of their first symptoms and 7 days after the insult. Age-matched controls were sampled on one occasion. We compared the expression of CD15 and CD64 on monocytes, granulocytes, and lymphocytes using flow cytometry. RESULTS The proportion of granulocytes and CD15+ granulocytes was comparable between controls and stroke patients at both time points. While the proportion of CD15bright granulocytes was also comparable, the mean fluorescence intensity (MFI) of CD15 on this subset was reduced in stroke patients by day 7 but was overall higher at both time points compared to controls. The MFI of CD15 on granulocytes was lower in stroke patients with failed TT than in those with successful TT 1 week after the insult. CONCLUSIONS Our current results indicate that TT may not only acutely reduce the systemic inflammatory response following stroke but may also play a role in reversing SIIS at a later stage following the insult, as reflected by the higher expression of the CD15 marker on granulocytes following successful TT.
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Affiliation(s)
| | - Ágnes Czeti
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Ferenc Takács
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Gábor Barna
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Dániel Kis
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Gabriella Róka
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - András Folyovich
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Gergely Toldi
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary.,Liggins Institute, University of Auckland, Auckland, New Zealand
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Pathophysiology of Sepsis and Genesis of Septic Shock: The Critical Role of Mesenchymal Stem Cells (MSCs). Int J Mol Sci 2022; 23:ijms23169274. [PMID: 36012544 PMCID: PMC9409099 DOI: 10.3390/ijms23169274] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
The treatment of sepsis and septic shock remains a major public health issue due to the associated morbidity and mortality. Despite an improvement in the understanding of the physiological and pathological mechanisms underlying its genesis and a growing number of studies exploring an even higher range of targeted therapies, no significant clinical progress has emerged in the past decade. In this context, mesenchymal stem cells (MSCs) appear more and more as an attractive approach for cell therapy both in experimental and clinical models. Pre-clinical data suggest a cornerstone role of these cells and their secretome in the control of the host immune response. Host-derived factors released from infected cells (i.e., alarmins, HMGB1, ATP, DNA) as well as pathogen-associated molecular patterns (e.g., LPS, peptidoglycans) can activate MSCs located in the parenchyma and around vessels to upregulate the expression of cytokines/chemokines and growth factors that influence, respectively, immune cell recruitment and stem cell mobilization. However, the way in which MSCs exert their beneficial effects in terms of survival and control of inflammation in septic states remains unclear. This review presents the interactions identified between MSCs and mediators of immunity and tissue repair in sepsis. We also propose paradigms related to the plausible roles of MSCs in the process of sepsis and septic shock. Finally, we offer a presentation of experimental and clinical studies and open the way to innovative avenues of research involving MSCs from a prognostic, diagnostic, and therapeutic point of view in sepsis.
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Li J, Zhou M, Feng JQ, Hong SM, Yang SY, Zhi LX, Lin WY, Zhu C, Yu YT, Lu LJ. Bulk RNA Sequencing With Integrated Single-Cell RNA Sequencing Identifies BCL2A1 as a Potential Diagnostic and Prognostic Biomarker for Sepsis. Front Public Health 2022; 10:937303. [PMID: 35832273 PMCID: PMC9272057 DOI: 10.3389/fpubh.2022.937303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/31/2022] [Indexed: 02/05/2023] Open
Abstract
Background Sepsis is one of the leading causes of morbidity and mortality worldwide in the intensive care unit (ICU). The prognosis of the disease strongly depends on rapid diagnosis and appropriate treatment. Thus, some new and accurate sepsis-related biomarkers are pressing needed and their efficiency should be carefully demonstrated. Methods Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were applied to detect sepsis and monocyte/macrophage-related genes. Least absolute shrinkage and selection operator (LASSO) and random forest regression analyses were used in combination to screen out prognostic genes. Single-cell RNA sequence profiling was utilized to further verify the expression of these genes on a single cell level. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were also applied to verify the diagnostic value of the target biomarkers. Results The intersections of the genes detected by differential expression and WGCNA analyses identified 141 overlapping candidate genes that were closely related to sepsis and macrophages. The LASSO and random forest regression analyses further screened out 17 prognostic genes. Single-cell RNA sequencing analysis detected that FCGR1A and BCL2A1 might be potential biomarkers for sepsis diagnosis and the diagnostic efficacy of BCL2A1 was further validated by ROC curve and DCA. Conclusions It was revealed that BCL2A1 had good diagnostic and prognostic value for sepsis, and that it can be applied as a potential and novel biomarker for the management of the disease.
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Affiliation(s)
- Jun Li
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mi Zhou
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Qi Feng
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Soon-Min Hong
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shao-Ying Yang
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lang-Xian Zhi
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wan-Yi Lin
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cheng Zhu
- Department of Disease Prevention and Control, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue-Tian Yu
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang-Jing Lu
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Souza-Moreira L, Tan Y, Wang Y, Wang JP, Salkhordeh M, Virgo J, Florian M, Murray AB, Watpool I, McIntyre L, English S, Stewart DJ, Mei SH. Poly(I:C) Enhances Mesenchymal Stem Cell Control of Myeloid Cells From COVID-19 Patients. iScience 2022; 25:104188. [PMID: 35402859 PMCID: PMC8975597 DOI: 10.1016/j.isci.2022.104188] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/25/2022] [Accepted: 03/30/2022] [Indexed: 01/08/2023] Open
Abstract
Mesenchymal stem cells (MSCs) are being studied for the treatment of COVID-19-associated critical illness, due to their immunomodulatory properties. Here, we hypothesized that viral mimic-priming improves MSCs’ abilities to rebalance the dysregulated immune responses in COVID-19. Transcriptome analysis of poly(I:C)-primed MSCs (pIC-MSCs) showed upregulation of pathways in antiviral and immunomodulatory responses. Together with increased expression of antiviral proteins such as MX1, IFITM3, and OAS1, these changes translated to greater effector functions in regulating monocytes and granulocytes while further enhancing MSCs’ ability to block SARS-CoV-2 pseudovirus entry into epithelial cells. Most importantly, the addition of pIC-MSCs to COVID-19 patient whole blood significantly reduced inflammatory neutrophils and increased M2 monocytes while enhancing their phagocytic effector function. We reveal for the first time that MSCs can be primed by Toll-like receptor 3 agonist to improve their ability to rebalance the dysregulated immune responses seen in severe SARS-CoV-2 infection. Viral stimuli mimic enhances MSC’s antiviral and immunomodulatory molecular profile pIC-primed MSCs inhibit SARS-CoV2 pseudovirus entry into epithelial cells pIC-MSCs recalibrate dysregulated cellular response in COVID patient’s whole blood
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Sendo F, Yoshitake H, Araki Y. Targeting of neutrophil activation in the early phase of the disease for prevention of Coronavirus disease-19 severity. Microbiol Immunol 2022; 66:264-276. [PMID: 35348252 PMCID: PMC9111295 DOI: 10.1111/1348-0421.12978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022]
Abstract
The prevention of the disease severity seems critical for reducing the mortality of Coronavirus (CoV) disease‐19. The neutrophils play a key role in the induction of severity. It is proposed here that inhibition of neutrophil activation and/or cascade reactions of complement, leading to this cell activation at the early phase of the disease, is a potential tool to inhibit aggravation of the disease. The need for appropriate timing in intervention is emphasized as follows. (1) Intervention at the very early stage of severe acute respiratory syndrome‐CoV‐2 infection may harm the defensive host response to the infection because of the critical function of neutrophils in this response, and (2) intervention at too late a stage will not stop the infiltration of fully activated neutrophils that produce large amounts of toxic substances.
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Affiliation(s)
| | - Hiroshi Yoshitake
- Institute for Environmental & Gender-specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Yoshihiko Araki
- Institute for Environmental & Gender-specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan.,Division of Microbiology, Department of Pathology & Microbiology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
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22
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Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review. Clin Pharmacokinet 2022; 61:593-617. [PMID: 35218003 PMCID: PMC9095522 DOI: 10.1007/s40262-021-01102-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 02/07/2023]
Abstract
The pathophysiology of sepsis alters drug pharmacokinetics, resulting in inadequate drug exposure and target-site concentration. Suboptimal exposure leads to treatment failure and the development of antimicrobial resistance. Therefore, we seek to optimize antimicrobial therapy in sepsis by selecting the right drug and the correct dosage. A prerequisite for achieving this goal is characterization and understanding of the mechanisms of pharmacokinetic alterations. However, most infections take place not in blood but in different body compartments. Since tissue pharmacokinetic assessment is not feasible in daily practice, we need to tailor antibiotic treatment according to the specific patient’s pathophysiological processes. The complex pathophysiology of sepsis and the ineffectiveness of current targeted therapies suggest that treatments guided by biomarkers predicting target-site concentration could provide a new therapeutic strategy. Inflammation, endothelial and coagulation activation markers, and blood flow parameters might be indicators of impaired tissue distribution. Moreover, hepatic and renal dysfunction biomarkers can predict not only drug metabolism and clearance but also drug distribution. Identification of the right biomarkers can direct drug dosing and provide timely feedback on its effectiveness. Therefore, this might decrease antibiotic resistance and the mortality of critically ill patients. This article fills the literature gap by characterizing patient biomarkers that might be used to predict unbound plasma-to-tissue drug distribution in critically ill patients. Although all biomarkers must be clinically evaluated with the ultimate goal of combining them in a clinically feasible scoring system, we support the concept that the appropriate biomarkers could be used to direct targeted antibiotic dosing.
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23
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Kraus RF, Gruber MA. Neutrophils-From Bone Marrow to First-Line Defense of the Innate Immune System. Front Immunol 2022; 12:767175. [PMID: 35003081 PMCID: PMC8732951 DOI: 10.3389/fimmu.2021.767175] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/03/2021] [Indexed: 12/16/2022] Open
Abstract
Neutrophils (polymorphonuclear cells; PMNs) form a first line of defense against pathogens and are therefore an important component of the innate immune response. As a result of poorly controlled activation, however, PMNs can also mediate tissue damage in numerous diseases, often by increasing tissue inflammation and injury. According to current knowledge, PMNs are not only part of the pathogenesis of infectious and autoimmune diseases but also of conditions with disturbed tissue homeostasis such as trauma and shock. Scientific advances in the past two decades have changed the role of neutrophils from that of solely immune defense cells to cells that are responsible for the general integrity of the body, even in the absence of pathogens. To better understand PMN function in the human organism, our review outlines the role of PMNs within the innate immune system. This review provides an overview of the migration of PMNs from the vascular compartment to the target tissue as well as their chemotactic processes and illuminates crucial neutrophil immune properties at the site of the lesion. The review is focused on the formation of chemotactic gradients in interaction with the extracellular matrix (ECM) and the influence of the ECM on PMN function. In addition, our review summarizes current knowledge about the phenomenon of bidirectional and reverse PMN migration, neutrophil microtubules, and the microtubule organizing center in PMN migration. As a conclusive feature, we review and discuss new findings about neutrophil behavior in cancer environment and tumor tissue.
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Affiliation(s)
- Richard Felix Kraus
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
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Liang J, Xu J, You L, Yang G, Niu G, Pan H, Yu S, Mai X, Xu J, Zhang F. Neutrophil CD64: a potential biomarker for the diagnosis of infection in patients with haematological malignancies. Hematology 2021; 26:970-975. [PMID: 34871536 DOI: 10.1080/16078454.2021.2003064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
METHODS The clinical data of 76 patients with haematological malignancies and infection who were treated in our department between January 2014 and October 2019 were retrospectively analysed. To evaluate the diagnostic value of some biomarkers, infection indexes such as white blood cell count (WBC), neutrophil count (NEUT), neutrophil CD64 and procalcitonin (PCT) were compared across the patients with confirmed infection status and infection-control status. Sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were also determined. RESULTS The WBC and NEUT did not differ significantly, whereas the neutrophil CD64 and PCT levels were significantly elevated in patients with a confirmed infection status (p < 0.05), with sensitivity of 31.0%, 45.2%, 76.2% and 50%, respectively, and specificity of 90.5%, 69%, 71.4% and 64.3%, respectively. The AUC of WBC, NEUT, neutrophil CD64 and PCT was 0.528, 0.517, 0.844 and 0.599, respectively. Further highlighting their diagnostic value, the neutrophil CD64 and PCT levels in neutropenia patients were significantly upregulated in patients with infection status (p < 0.05) but the WBC and NEUT were unchanged, with sensitivity of 73.7%, 63.2%, 68% and 68.4%, respectively, and specificity of 68.4%, 52.6%, 57.9% and 63.2%, respectively. The AUC of neutrophil CD64, PCT, WBC and NEUT was 0.864, 0.593, 0.419 and 0.403, respectively. CONCLUSION These results indicate that neutrophil CD64 is a promising biomarker with superior sensitivity and specificity for diagnosing infection in patients with haematological malignancies, especially neutropenia patients.
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Affiliation(s)
- Jiabao Liang
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Jiayu Xu
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Lu You
- Department of Nephrology, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Guolei Yang
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Guomin Niu
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Huanyu Pan
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Sijian Yu
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Xiuqu Mai
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Jialiang Xu
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
| | - Fuhua Zhang
- Department of Hematology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, People's Republic of China
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Koenderman L, Siemers MJ, van Aalst C, Bongers SH, Spijkerman R, Bindels BJJ, Giustarini G, van Goor HMR, Kaasjager KAH, Vrisekoop N. The Systemic Immune Response in COVID-19 Is Associated with a Shift to Formyl-Peptide Unresponsive Eosinophils. Cells 2021; 10:cells10051109. [PMID: 34062964 PMCID: PMC8147959 DOI: 10.3390/cells10051109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 12/21/2022] Open
Abstract
A malfunction of the innate immune response in COVID-19 is associated with eosinopenia, particularly in more severe cases. This study tested the hypothesis that this eosinopenia is COVID-19 specific and is associated with systemic activation of eosinophils. Blood of 15 healthy controls and 75 adult patients with suspected COVID-19 at the ER were included before PCR testing and analyzed by point-of-care automated flow cytometry (CD10, CD11b, CD16, and CD62L) in the absence or presence of a formyl peptide (fNLF). Forty-five SARS-CoV-2 PCR positive patients were grouped based on disease severity. PCR negative patients with proven bacterial (n = 20) or other viral (n = 10) infections were used as disease controls. Eosinophils were identified with the use of the FlowSOM algorithm. Low blood eosinophil numbers (<100 cells/μL; p < 0.005) were found both in patients with COVID-19 and with other infectious diseases, albeit less pronounced. Two discrete eosinophil populations were identified in healthy controls both before and after activation with fNLF based on the expression of CD11b. Before activation, the CD11bbright population consisted of 5.4% (CI95% = 3.8, 13.4) of total eosinophils. After activation, this population of CD11bbright cells comprised nearly half the population (42.21%, CI95% = 35.9, 54.1). Eosinophils in COVID-19 had a similar percentage of CD11bbright cells before activation (7.6%, CI95% = 4.5, 13.6), but were clearly refractory to activation with fNLF as a much lower percentage of cells end up in the CD11bbright fraction after activation (23.7%, CI95% = 18.5, 27.6; p < 0.001). Low eosinophil numbers in COVID-19 are associated with refractoriness in responsiveness to fNLF. This might be caused by migration of fully functional cells to the tissue.
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Affiliation(s)
- Leo Koenderman
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
- Correspondence: ; Tel.: +31-88-7556180
| | - Maarten J. Siemers
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
| | - Corneli van Aalst
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
| | - Suzanne H. Bongers
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
- Department of Trauma Surgery, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands
| | - Roy Spijkerman
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
| | - Bas J. J. Bindels
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
| | - Giulio Giustarini
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
| | - Harriët M. R. van Goor
- Department of Internal Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (H.M.R.v.G.); (K.A.H.K.)
| | - Karin A. H. Kaasjager
- Department of Internal Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (H.M.R.v.G.); (K.A.H.K.)
| | - Nienke Vrisekoop
- Department of Respiratory Medicine, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands; (M.J.S.); (C.v.A.); (R.S.); (B.J.J.B.); (G.G.); (N.V.)
- Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands;
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Gasparoto TH, Dalboni TM, Amôr NG, Abe AE, Perri G, Lara VS, Vieira NA, Gasparoto CT, Campanelli AP. Fcγ receptors on aging neutrophils. J Appl Oral Sci 2021; 29:e20200770. [PMID: 33825754 PMCID: PMC8011831 DOI: 10.1590/1678-7757-2020-0770] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Neutrophils are key effector cells of the innate immune system. They recognize antigens through membrane receptors, which are expressed during their maturation and activation. Neutrophils express FcγRII (CD32), FcγRIII (CD16), and FcγRI (CD64) after being activated by different factors such as cytokines and bacterial products. These receptors are involved with phagocytosis of IgG-opsonized microbes and enhance defense mechanisms. Based on that, our study seeks to compare the expression of FcγRII, FcγRIII, FcγRI, and CD11b on neutrophils from elderly and young subjects and their expression after in vitro activation with cytokines and LPS. METHODOLOGY Neutrophils were isolated from human peripheral blood and from mice bone marrow by density gradient. After isolation, FCγRs expression was immediately analyzed by flow cytometry or after in vitro stimulation. RESULTS In freshly isolated cells, the percentage of FcγRIIIb+ and CD11b+ neutrophils were higher in samples from young individuals; FcγRIIIa expression was more prominent on aged neutrophils; FcγRIA expression was similar in all samples analyzed. Exposure to CXCL8 and LPS resulted in a higher percentage of FcγRIa+ neutrophils on elderly individuals' samples but lower when compared with neutrophils from young donors. We observed that LPS caused an increase in FcγRIIa expression on aging human neutrophils. In contrast, FcγRIIIb expression in response to CXCL8 and LPS stimulation was not altered in the four groups. CD11b expression was lower in neutrophils from elderly individuals even in response to LPS and CXCL8. In mice, we observed differences only regarding CD11b expression, which was increased on aged neutrophils. LPS exposure caused an increase in all FcγRs. CONCLUSIONS Our results suggest that, in humans, the overall pattern of FcγR expression and integrin CD11b are altered during aging and immunosenescence might contribute to age-related infection.
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Affiliation(s)
- Thaís Helena Gasparoto
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Thalita Marcato Dalboni
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Nádia Ghinelli Amôr
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Aneli Eiko Abe
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Graziela Perri
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Vanessa Soares Lara
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Estomatologia (Patologia Oral), Bauru, SP, Brasil
| | | | - Carlos Teodoro Gasparoto
- Universidade de São Paulo, Faculdade de Medicina de São Paulo, Departamento de Saúde Pública, São Paulo, Brasil
| | - Ana Paula Campanelli
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
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Rohil A, Dutta S, Varma N, Sachdev MS, Bansal A, Kumar P. Cell-Surface Biomarkers, C-Reactive Protein and Haematological Parameters for Diagnosing Late Onset Sepsis in Pre-term Neonates. J Trop Pediatr 2021; 67:6169400. [PMID: 33712846 DOI: 10.1093/tropej/fmab016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the diagnostic accuracy of white blood cell-surface biomarkers (CD64, CD11b and HLA-DR), C-reactive protein (CRP) and hematological parameters to diagnose definite sepsis among pre-term neonates presenting with suspected late-onset neonatal sepsis (LONS). DESIGN This was a prospective, single-gate, diagnostic study in a Level III neonatal unit. Fifty-three neonates (gestation, <34 weeks) with LONS (onset, >72 age), were enrolled. Cell-surface biomarkers, CRP and haematological parameters were assayed at 0 and 48 h after onset. The reference standard was definite sepsis, defined as a positive blood culture with a non-contaminant organism. The index tests (cell-surface biomarkers, CRP and haematological parameters) were compared between subjects with or without 'definite sepsis'. The area under the receiver operator characteristics curves (AUC) generated for each index test at 0 and 48 h was compared. SETTING Level III neonatal unit in a tertiary care institute. RESULTS Of 53 enrolled pre-term infants, 24 had definite sepsis. Among all the index tests evaluated, CRP at 48 h had the highest AUC [0.82 (95% confidence interval, 0.69, 0.92)]. The expression of CD11b and HLA-DR was significantly reduced among the septic neonates. Among the cell-surface biomarkers, the maximum AUC was recorded for HLA-DR at 48 [0.68 (95% CI, 0.54, 0.81)]. Comparisons between index tests were not statistically significant. CONCLUSION C-reactive protein is superior to other sepsis screen biomarkers and white blood cell-surface biomarkers in diagnosing culture-positive LONS among pre-term infants. CD64, CD11b and HLA DR as diagnostic tests in this group have limited discriminatory value. LAY SUMMARY The diagnosis of neonatal blood stream infections is a challenge. In response to bacterial blood stream infections, white blood cells are known to produce an excess of certain types of specialized proteins on their surface, including CD64, CD11b and HLA-DR. In this study we evaluated the concentration of these cell-surface proteins for diagnosing blood stream infections in pre-mature newborn babies, whose onset of infection was beyond 72 h of life. We compared these tests against standard tests that are currently in clinical use, such as C-reactive protein and blood white cell counts. All tests were performed at the time of initially suspecting the infection and 48 h later. The gold standard against which all these tests were evaluated was blood culture, in which the offending bacteria are grown in specialized laboratory media. Of 53 pre-mature babies with suspected infection, 24 had blood culture-proven infection. Among all tests, C-reactive protein at 48 h had the best ability to distinguish definite infection from no infection. The expression of CD11b and HLA-DR was significantly reduced among infected neonates. We conclude that C-reactive protein is superior to white blood cell-surface proteins and white cell count in diagnosing definite late-onset infections among pre-term infants.
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Affiliation(s)
- Aradhana Rohil
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sourabh Dutta
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Neelam Varma
- Department of Hematology, PGIMER, Chandigarh, India
| | | | - Arun Bansal
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Praveen Kumar
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Xu JL, Guo Y. FCGR1A Serves as a Novel Biomarker and Correlates With Immune Infiltration in Four Cancer Types. Front Mol Biosci 2020; 7:581615. [PMID: 33344503 PMCID: PMC7744780 DOI: 10.3389/fmolb.2020.581615] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/03/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND FCGR1A encodes a protein that plays an important role in the immune response. The prognostic impact and immune infiltration of FCGR1A in heterogeneous cancers remain unclear. METHODS Differential expression of FCGR1A between tumor and normal tissues and the discrepancies in overall survival (OS) among diverse cancer types were performed by Gene Expression Profiling Interactive Analysis. The correlation between FCGR1A and immune cells or gene marker sets of immune infiltrates was analyzed via Tumor Immune Estimation Resource (TIMER). Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, and protein-to-protein interaction (PPI) network were used to explore the function and related genes of FCGR1A. The relationships among these genes were further analyzed by TIMER. RESULTS FCGR1A is highly expressed in various cancer types. FCGR1A was significantly correlated with the OS of cervical and endocervical cancer (CESC), cholangiocarcinoma (CHOL), kidney renal clear cell carcinoma (KIRC), and skin cutaneous melanoma (SKCM) (P < 0.05). High expression of FCGR1A meant a better prognosis besides KIRC. FCGR1A showed significant differences at different stages of KIRC and SKCM (P < 0.05). Furthermore, FCGR1A was notably associated with infiltrating levels of CD4+ T cells, CD8+ T cells, B cells, macrophages, neutrophils, and dendritic cells in the four cancers (P < 0.05). FCGR1A also showed close relevance with different immune gene markers. The copy number variation of FCGR1A significantly influenced the abundance of immune infiltration in KIRC and SKCM. GO, KEGG analysis, and PPI network analysis revealed that FCGR1A is involved in many pathophysiological processes and was most related to FCGR3A. And this gene indicated highly significant positive correlations with FCGR1A in four cancers. CONCLUSION FCGR1A may be a potential prognostic biomarker and related to immune infiltration levels in diverse cancers, especially in CESC, CHOL, KIRC, and SKCM. Besides, FCGR1A may be involved in the activation, regulation, or induction of immune cells and diverse physiological and pathological processes.
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Affiliation(s)
- Ji-li Xu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yong Guo
- Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China
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Patnaik R, Azim A, Agarwal V. Neutrophil CD64 a Diagnostic and Prognostic Marker of Sepsis in Adult Critically Ill Patients: A Brief Review. Indian J Crit Care Med 2020; 24:1242-1250. [PMID: 33446980 PMCID: PMC7775945 DOI: 10.5005/jp-journals-10071-23558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Sepsis is a life-threatening organ dysfunction with increased incidence of morbidity and mortality. Early diagnosis and prompt therapeutic intervention is the cornerstone of sepsis care. Biomarkers play an important role in sepsis having both diagnostic and prognostic implications. Neutrophil CD64 (nCD64) is a useful candidate biomarker for sepsis. Neutrophil CD64 also known as Fc receptor 1 (FcR1), is a high-affinity receptor present on neutrophils for Fc part of immunoglobulin-G (IgG) heavy chain. Its expression gets strongly upregulated in response to proinflammatory cytokines of infection within 4-6 hours. Neutrophil CD64 integrates function involving both innate and adaptive immune responses. The aim of this review is to present literature about nCD64 as a diagnostic and prognostic marker in patients with sepsis/septic shock. BACKGROUND The authors searched articles over 13 years, i.e., from 2006 to 2019. They included articles written in English only and further reviewed the reference list of selected articles to obtain potentially relevant articles. Reviews, letters, commentaries, correspondences, case reports, conference abstracts, expert opinions, editorials, and animal experiments were excluded. Articles involving pediatric patients (≤18 years) were also excluded. REVIEW RESULTS Several studies have indicated that nCD64 is a highly sensitive and specific marker for the diagnosis of sepsis. Various combinations of biomarkers have been used with nCD64 for a better diagnostic value. Neutrophil CD64 as a prognostic marker in critically ill patients needs to be explored more. Most of the existing literatures have highlighted its prognostic utility based on single value at enrolment. There are limited literatures on prognostic implications of serial trend and kinetics of nCD64. CONCLUSION Neutrophil CD64 is a useful diagnostic and prognostic marker of sepsis in critically ill patients. Additional studies are needed on nCD64 in sepsis based on sepsis-3 criteria. Further trials with large sample size are needed to establish prognostic implications of serial nCD64 trend. HOW TO CITE THIS ARTICLE Patnaik R, Azim A, Agarwal V. Neutrophil CD64 a Diagnostic and Prognostic Marker of Sepsis in Adult Critically Ill Patients: A Brief Review. Indian J Crit Care Med 2020;24(12):1242-1250.
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Affiliation(s)
- Rupali Patnaik
- Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Afzal Azim
- Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vikas Agarwal
- Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Zhang Y, Gao H, Li H, Guo J, Ouyang B, Wang M, Xu Q, Wang J, Lv M, Guo X, Liu Q, Wei L, Ren H, Xi Y, Guo Y, Ren B, Pan S, Liu C, Ding X, Xiang H, Yu Y, Song Y, Meng L, Liu S, Wang J, Jiang Y, Shi J, Liu S, Sabir JSM, Sabir MJ, Khan M, Hajrah NH, Ming-Yuen Lee S, Xu X, Yang H, Wang J, Fan G, Yang N, Liu X. The White-Spotted Bamboo Shark Genome Reveals Chromosome Rearrangements and Fast-Evolving Immune Genes of Cartilaginous Fish. iScience 2020; 23:101754. [PMID: 33251490 PMCID: PMC7677710 DOI: 10.1016/j.isci.2020.101754] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 09/17/2020] [Accepted: 10/28/2020] [Indexed: 01/27/2023] Open
Abstract
Chondrichthyan (cartilaginous fish) occupies a key phylogenetic position and is important for investigating evolutionary processes of vertebrates. However, limited whole genomes impede our in-depth knowledge of important issues such as chromosome evolution and immunity. Here, we report the chromosome-level genome of white-spotted bamboo shark. Combing it with other shark genomes, we reconstructed 16 ancestral chromosomes of bamboo shark and illustrate a dynamic chromosome rearrangement process. We found that genes on 13 fast-evolving chromosomes can be enriched in immune-related pathways. And two chromosomes contain important genes that can be used to develop single-chain antibodies, which were shown to have high affinity to human disease markers by using enzyme-linked immunosorbent assay. We also found three bone formation-related genes were lost due to chromosome rearrangements. Our study highlights the importance of chromosome rearrangements, providing resources for understanding of cartilaginous fish diversification and potential application of single-chain antibodies. Inferred ancestral chromosome karyotypes of cartilaginous fish Chromosome rearrangements resulted in fast-evolving chromosomes and immune genes Chromosome rearrangements led to deletion of bone formation-related genes Proved that single-domain antibodies in shark have great potential application
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Affiliation(s)
- Yaolei Zhang
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China.,Department of Biotechnology and Biomedicine, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Haoyang Gao
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Hanbo Li
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Jiao Guo
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Bingjie Ouyang
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Meiniang Wang
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Qiwu Xu
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Jiahao Wang
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Meiqi Lv
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Xinyu Guo
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Qun Liu
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Likun Wei
- City University of Hongkong, Kowloon, Hongkong SAR
| | - Han Ren
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Yang Xi
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Yang Guo
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Bingzhao Ren
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Shanshan Pan
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Chuxin Liu
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Xiaoyan Ding
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Haitao Xiang
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Yingjia Yu
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Yue Song
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Lingfeng Meng
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Shanshan Liu
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Jun Wang
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Yuan Jiang
- BGI-Shenzhen, Shenzhen 518083, China.,Complete Genomics, Inc., San Jose, CA 95134, USA
| | - Jiahai Shi
- City University of Hongkong, Kowloon, Hongkong SAR
| | - Shiping Liu
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Jamal S M Sabir
- Department of Biological Sciences, King Abdulaziz University (KAU), Jeddah 21589, Saudi Arabia
| | - Mumdooh J Sabir
- Department of Biological Sciences, King Abdulaziz University (KAU), Jeddah 21589, Saudi Arabia
| | - Muhummadh Khan
- Department of Biological Sciences, King Abdulaziz University (KAU), Jeddah 21589, Saudi Arabia
| | - Nahid H Hajrah
- Department of Biological Sciences, King Abdulaziz University (KAU), Jeddah 21589, Saudi Arabia
| | - Simon Ming-Yuen Lee
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, Macao, China
| | - Xun Xu
- BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen 518083, China.,James D. Watson Institute of Genome Sciences, Hangzhou 310058, China
| | - Jian Wang
- BGI-Shenzhen, Shenzhen 518083, China.,James D. Watson Institute of Genome Sciences, Hangzhou 310058, China
| | - Guangyi Fan
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, Macao, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
| | - Naibo Yang
- BGI-Shenzhen, Shenzhen 518083, China.,Complete Genomics, Inc., San Jose, CA 95134, USA
| | - Xin Liu
- BGI-Qingdao, BGI-Shenzhen, Qingdao 266555, China.,BGI-Shenzhen, Shenzhen 518083, China.,China National GeneBank, BGI-Shenzhen, Shenzhen 518120, China
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31
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Wang L, Ai Z, Khoyratty T, Zec K, Eames HL, van Grinsven E, Hudak A, Morris S, Ahern D, Monaco C, Eruslanov EB, Luqmani R, Udalova IA. ROS-producing immature neutrophils in giant cell arteritis are linked to vascular pathologies. JCI Insight 2020; 5:139163. [PMID: 32960815 PMCID: PMC7605529 DOI: 10.1172/jci.insight.139163] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022] Open
Abstract
Giant cell arteritis (GCA) is a common form of primary systemic vasculitis in adults, with no reliable indicators of prognosis or treatment responses. We used single cell technologies to comprehensively map immune cell populations in the blood of patients with GCA and identified the CD66b+CD15+CD10lo/–CD64– band neutrophils and CD66bhiCD15+CD10lo/–CD64+/bright myelocytes/metamyelocytes to be unequivocally associated with both the clinical phenotype and response to treatment. Immature neutrophils were resistant to apoptosis, remained in the vasculature for a prolonged period of time, interacted with platelets, and extravasated into the tissue surrounding the temporal arteries of patients with GCA. We discovered that immature neutrophils generated high levels of extracellular reactive oxygen species, leading to enhanced protein oxidation and permeability of endothelial barrier in an in vitro coculture system. The same populations were also detected in other systemic vasculitides. These findings link functions of immature neutrophils to disease pathogenesis, establishing a clinical cellular signature of GCA and suggesting different therapeutic approaches in systemic vascular inflammation. Bona fide immature neutrophil subsets produce unchecked extracellular ROS that contributes to vascular pathologies.
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Affiliation(s)
| | | | | | | | | | | | - Alison Hudak
- Botnar Research Centre, Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Headington, Oxford, United Kingdom
| | - Susan Morris
- Botnar Research Centre, Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Headington, Oxford, United Kingdom
| | | | | | - Evgeniy B Eruslanov
- Division of Thoracic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Raashid Luqmani
- Botnar Research Centre, Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Headington, Oxford, United Kingdom
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32
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Fine N, Tasevski N, McCulloch CA, Tenenbaum HC, Glogauer M. The Neutrophil: Constant Defender and First Responder. Front Immunol 2020; 11:571085. [PMID: 33072112 PMCID: PMC7541934 DOI: 10.3389/fimmu.2020.571085] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/24/2020] [Indexed: 12/21/2022] Open
Abstract
The role of polymorphonuclear neutrophils (PMNs) in biology is often recognized during pathogenesis associated with PMN hyper- or hypo-functionality in various disease states. However, in the vast majority of cases, PMNs contribute to resilience and tissue homeostasis, with continuous PMN-mediated actions required for the maintenance of health, particularly in mucosal tissues. PMNs are extraordinarily well-adapted to respond to and diminish the damaging effects of a vast repertoire of infectious agents and injurious processes that are encountered throughout life. The commensal biofilm, a symbiotic polymicrobial ecosystem that lines the mucosal surfaces, is the first line of defense against pathogenic strains that might otherwise dominate, and is therefore of critical importance for health. PMNs regularly interact with the commensal flora at the mucosal tissues in health and limit their growth without developing an overt inflammatory reaction to them. These PMNs exhibit what is called a para-inflammatory phenotype, and have reduced inflammatory output. When biofilm growth and makeup are disrupted (i.e., dysbiosis), clinical symptoms associated with acute and chronic inflammatory responses to these changes may include pain, erythema and swelling. However, in most cases, these responses indicate that the immune system is functioning properly to re-establish homeostasis and protect the status quo. Defects in this healthy everyday function occur as a result of PMN subversion by pathological microbial strains, genetic defects or crosstalk with other chronic inflammatory conditions, including cancer and rheumatic disease, and this can provide some avenues for therapeutic targeting of PMN function. In other cases, targeting PMN functions could worsen the disease state. Certain PMN-mediated responses to pathogens, for example Neutrophil Extracellular Traps (NETs), might lead to undesirable symptoms such as pain or swelling and tissue damage/fibrosis. Despite collateral damage, these PMN responses limit pathogen dissemination and more severe damage that would otherwise occur. New data suggests the existence of unique PMN subsets, commonly associated with functional diversification in response to particular inflammatory challenges. PMN-directed therapeutic approaches depend on a greater understanding of this diversity. Here we outline the current understanding of PMNs in health and disease, with an emphasis on the positive manifestations of tissue and organ-protective PMN-mediated inflammation.
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Affiliation(s)
- Noah Fine
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Nikola Tasevski
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Howard C Tenenbaum
- Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Dental Oncology, Maxillofacial and Ocular Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada
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33
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Weiß E, Schlatterer K, Beck C, Peschel A, Kretschmer D. Formyl-Peptide Receptor Activation Enhances Phagocytosis of Community-Acquired Methicillin-Resistant Staphylococcus aureus. J Infect Dis 2020; 221:668-678. [PMID: 31573600 DOI: 10.1093/infdis/jiz498] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/27/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Formyl-peptide receptors (FPRs) are important pattern recognition receptors that sense specific bacterial peptides. Formyl-peptide receptors are highly expressed on neutrophils and monocytes, and their activation promotes the migration of phagocytes to sites of infection. It is currently unknown whether FPRs may also influence subsequent processes such as bacterial phagocytosis and killing. Staphylococcus aureus, especially highly pathogenic community-acquired methicillin-resistant S aureus strains, release high amounts of FPR2 ligands, the phenol-soluble modulins. METHODS We demonstrate that FPR activation leads to upregulation of complement receptors 1 and 3 as well as FCγ receptor I on neutrophils and, consequently, increased opsonic phagocytosis of S aureus and other pathogens. RESULTS Increased phagocytosis promotes killing of S aureus and interleukin-8 release by neutrophils. CONCLUSIONS We show here for the first time that FPRs govern opsonic phagocytosis. Manipulation of FPR2 activation could open new therapeutic opportunities against bacterial pathogens.
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Affiliation(s)
- Elisabeth Weiß
- Infection Biology, Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany
| | - Katja Schlatterer
- Infection Biology, Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany
| | - Christian Beck
- Infection Biology, Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany
| | - Andreas Peschel
- Infection Biology, Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany
| | - Dorothee Kretschmer
- Infection Biology, Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany
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34
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Huot S, Laflamme C, Fortin PR, Boilard E, Pouliot M. IgG-aggregates rapidly upregulate FcgRI expression at the surface of human neutrophils in a FcgRII-dependent fashion: A crucial role for FcgRI in the generation of reactive oxygen species. FASEB J 2020; 34:15208-15221. [PMID: 32946139 DOI: 10.1096/fj.202001085r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 01/17/2023]
Abstract
Autoimmune complexes are an important feature of several autoimmune diseases such as lupus, as they contribute to tissue damage through the activation of immune cells. Neutrophils, key players in lupus, interact with immune complexes through Fc gamma receptors (FcgR). Incubation of neutrophils with aggregated-IgGs caused degranulation and increased the surface expression of FcgRI within minutes in a concentration-dependent fashion. After 30 minutes, IgG aggregates (1 mg/mL) upregulated FcgRI by 4.95 ± 0.45-fold. FcgRI-positive neutrophils reached 67.24% ± 6.88% on HA-IgGs stimulated neutrophils, from 3.12% ± 1.62% in non-stimulated cells, ranking IgG-aggregates among the most potent known agonists. FcgRIIa, and possibly FcgRIIIa, appeared to mediate this upregulation. Also, FcgRI-dependent signaling proved necessary for reactive oxygen species (ROS) production in response to IgG-aggregates. Finally, combinations of bacterial materials with aggregates dramatically boosted ROS production. This work suggests FcgRI as an essential component in the response of human neutrophils to immune complexes leading to the production of ROS, which may help explain how neutrophils contribute to tissue damage associated with immune complex-associated diseases, such as lupus.
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Affiliation(s)
- Sandrine Huot
- Département de microbiologie et immunologie, Faculté de Médecine de l'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada.,Axe maladies infectieuses et immunitaires, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
| | - Cynthia Laflamme
- Département de microbiologie et immunologie, Faculté de Médecine de l'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada.,Axe maladies infectieuses et immunitaires, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
| | - Paul R Fortin
- Axe maladies infectieuses et immunitaires, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada.,Division de Rhumatologie, Département de Médecine, CHU de Québec-Université Laval, Québec City, QC, Canada
| | - Eric Boilard
- Département de microbiologie et immunologie, Faculté de Médecine de l'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada.,Axe maladies infectieuses et immunitaires, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
| | - Marc Pouliot
- Département de microbiologie et immunologie, Faculté de Médecine de l'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada.,Axe maladies infectieuses et immunitaires, Centre de Recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
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35
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Webber RJ, Sweet RM, Webber DS. Inducible Nitric Oxide Synthase in Circulating Microvesicles: Discovery, Evolution, and Evidence as a Novel Biomarker and the Probable Causative Agent for Sepsis. J Appl Lab Med 2020; 3:698-711. [PMID: 30937423 DOI: 10.1373/jalm.2018.026377] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The sepsis pathology remains an enormous medical problem globally because morbidity and mortality remain unacceptably high in septic patients despite intense research efforts. The economic and societal burden of sepsis makes it the most pressing patient care issue in the United States and worldwide. Sepsis is a dysregulated immune response normally initiated by an infection. The need for an early, accurate, and reliable biomarker test to detect the onset of sepsis and for a targeted sepsis therapy are widely recognized in the biomedical community. Content This report reviews the published findings relevant to microvesicle-associated inducible nitric oxide synthase (MV-A iNOS) as a novel plasma biomarker for the onset of sepsis including human clinical studies and animal studies. Plasma iNOS as a standalone test and as one of the components of a novel panel of biomarkers to stage the progression of sepsis are presented and discussed in comparison to other biomarkers and other proposed panels of biomarkers for sepsis. Summary The data strongly support the concept that extracellular plasma MV-A iNOS in circulating microvesicles is centrally involved in the initiation of sepsis, and a diagnostic test based upon plasma iNOS can serve as an early pre-symptomatic warning signal for the onset of sepsis. A novel panel of plasma biomarkers comprised of iNOS, pro-IL-18, pro-IL-33, and Reg-1α is proposed as a multianalyte pre-symptomatic method to stage the onset of sepsis for improved prompt data driven patient care.
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Affiliation(s)
| | - Richard M Sweet
- School of Medicine, University of California San Francisco and Renal Department, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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36
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Hesselink L, Spijkerman R, Hellebrekers P, van Bourgondiën RJ, Blasse E, Haitjema S, Huisman A, van Solinge WW, Van Wessem KJP, Koenderman L, Leenen LPH, Hietbrink F. Fragile neutrophils in surgical patients: A phenomenon associated with critical illness. PLoS One 2020; 15:e0236596. [PMID: 32750099 PMCID: PMC7402494 DOI: 10.1371/journal.pone.0236596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/08/2020] [Indexed: 01/15/2023] Open
Abstract
Leukocyte viability (determined by e.g. propidium iodide [PI] staining) is automatically measured by hematology analyzers to check for delayed bench time. Incidental findings in fresh blood samples revealed the existence of leukocytes with decreased viability in critically ill surgical patients. Not much is known about these cells and their functional and/or clinical implications. Therefore, we investigated the incidence of decreased leukocyte viability, the implications for leukocyte functioning and its relation with clinical outcomes. An automated alarm was set in a routine hematology analyzer (Cell-Dyn Sapphire) for the presence of non-viable leukocytes characterized by increased fluorescence in the PI-channel (FL3:630±30nm). Patients with non-viable leukocytes were prospectively included and blood samples were drawn to investigate leukocyte viability in detail and to investigate leukocyte functioning (phagocytosis and responsiveness to a bacterial stimulus). Then, a retrospective analysis was conducted to investigate the incidence of fragile neutrophils in the circulation and clinical outcomes of surgical patients with fragile neutrophils hospitalized between 2013–2017. A high FL3 signal was either caused by 1) neutrophil autofluorescence which was considered false positive, or by 2) actual non-viable PI-positive neutrophils in the blood sample. These two causes could be distinguished using automatically generated data from the hematology analyzer. The non-viable (PI-positive) neutrophils proved to be viable (PI-negative) in non-lysed blood samples, and were therefore referred to as ‘fragile neutrophils’. Overall leukocyte functioning was not impaired in patients with fragile neutrophils. Of the 11 872 retrospectively included surgical patients, 75 (0.63%) were identified to have fragile neutrophils during hospitalization. Of all patients with fragile neutrophils, 75.7% developed an infection, 70.3% were admitted to the ICU and 31.3% died during hospitalization. In conclusion, fragile neutrophils occur in the circulation of critically ill surgical patients. These cells can be automatically detected during routine blood analyses and are an indicator of critical illness.
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Affiliation(s)
- Lillian Hesselink
- Department of trauma surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Translational Immunology, Wilhelmina Children’s Hospital, Utrecht, the Netherlands
- * E-mail: (FH); (LH)
| | - Roy Spijkerman
- Department of trauma surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Translational Immunology, Wilhelmina Children’s Hospital, Utrecht, the Netherlands
| | - Pien Hellebrekers
- Department of trauma surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Translational Immunology, Wilhelmina Children’s Hospital, Utrecht, the Netherlands
| | | | - Enja Blasse
- Department of Clinical Chemistry and Hematology, Utrecht, the Netherlands
| | - Saskia Haitjema
- Department of Clinical Chemistry and Hematology, Utrecht, the Netherlands
| | - Albert Huisman
- Department of Clinical Chemistry and Hematology, Utrecht, the Netherlands
| | | | | | - Leo Koenderman
- Center for Translational Immunology, Wilhelmina Children’s Hospital, Utrecht, the Netherlands
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Luke P. H. Leenen
- Department of trauma surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Falco Hietbrink
- Department of trauma surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- * E-mail: (FH); (LH)
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37
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Hanna MOF, Abdelhameed AM, Abou-Elalla AA, Hassan RM, Kostandi I. Neutrophil and monocyte receptor expression in patients with sepsis: implications for diagnosis and prognosis of sepsis. Pathog Dis 2020; 77:5581499. [PMID: 31584643 DOI: 10.1093/femspd/ftz055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/03/2019] [Indexed: 12/16/2022] Open
Abstract
Understanding the complex immune responses in sepsis is crucial to provide insight into the clinical syndrome. We evaluated the changes in the surface receptors of the cells of innate immunity, neutrophils and monocytes, in patients with sepsis. Since sepsis remains a clinical challenge, we aimed to assess the significance of altered receptor expression in diagnosis and prognosis. Critically ill patients with sepsis (n=31) were investigated for the expression of receptors for IgG heavy chain CD64 and CD16 on neutrophils and CD64 and the lipopolysaccharide receptor CD14 on monocytes by flow cytometry and compared to 23 patients with no sepsis. Patients with sepsis had increased expression of neutrophil CD64. Neutrophil CD64 was specific for discriminating patients with sepsis but showed weak sensitivity. When integrated in a scoring system, neutrophil CD64 in combination with C-reactive protein (CRP) and SOFA score showed a diagnostic accuracy of 0.93 for sepsis and significantly predicted increased mortality risk. While neutrophil CD16 did not discriminate for sepsis, decreased expression was associated with increased mortality risk. In contrast, monocyte CD64 and CD14 expression was unaltered in sepsis and was not associated with mortality risk. Our study demonstrates that unlike monocytes, neutrophil receptor expression is altered in patients with sepsis receiving intensive care. It is promising to apply a combination approach to diagnose sepsis especially in time-limited conditions.
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Affiliation(s)
- Mariam Onsy F Hanna
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Al-Saray st., Al-Manial, 11532, Egypt
| | - Asmaa M Abdelhameed
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Al-Saray st., Al-Manial, 11532, Egypt
| | - Amany A Abou-Elalla
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Misr University for Science and Technology, 6th of October City, Al-Motamyez District, 77, Egypt
| | - Reem M Hassan
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Al-Saray st., Al-Manial, 11532, Egypt
| | - Inas Kostandi
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Al-Saray st., Al-Manial, 11532, Egypt
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38
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Yin WP, Li JB, Zheng XF, An L, Shao H, Li CS. Effect of neutrophil CD64 for diagnosing sepsis in emergency department. World J Emerg Med 2020; 11:79-86. [PMID: 32076472 DOI: 10.5847/wjem.j.1920-8642.2020.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The aim of this study is to investigate the diagnostic and prognostic value of neutrophil CD64 (nCD64) as a novel biomarker in sepsis patients. METHODS One hundred fifty-one adult patients diagnosed with sepsis and 20 age-matched healthy controls were enrolled in the study. Patients with sepsis were further subdivided into a sepsis group and a septic shock group. nCD64 expression, serum procalcitonin (PCT) level, C-reactive protein (CRP) level, and white blood cell (WBC) count were obtained for each patient, and Sequential Organ Failure Assessment (SOFA) scores were calculated. RESULTS nCD64 expression was higher in the sepsis group with confirmed infection than in the control group. The receiver operating characteristic (ROC) curve of nCD64 was higher than those of SOFA score, PCT, CRP and WBC for diagnosing infection. The area under the curve (AUC) of nCD64 combined with SOFA score was the highest for all parameters. The AUC of nCD64 for predicting 28-day mortality in sepsis was significantly higher than those of PCT, CRP, and WBC, but slightly lower than that of SOFA score. The AUC of nCD64 or PCT combined with SOFA score was significantly higher than that of any single parameter for predicting 28-day mortality. CONCLUSION nCD64 expression and SOFA score are valuable parameters for early diagnosis of infection and prognostic evaluation of sepsis patients.
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Affiliation(s)
- Wen-Peng Yin
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jia-Bao Li
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Xiao-Fang Zheng
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Le An
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Huan Shao
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Chun-Sheng Li
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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Shao SL, Cong HY, Wang MY, Liu P. The diagnostic roles of neutrophil in bloodstream infections. Immunobiology 2019; 225:151858. [PMID: 31836303 DOI: 10.1016/j.imbio.2019.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/15/2019] [Accepted: 10/15/2019] [Indexed: 12/21/2022]
Abstract
Bloodstream infections remain a leading cause of death worldwide, despite advances in critical care and understanding of the pathophysiology and treatment strategies. No specific biomarkers or therapy are available for these conditions. Neutrophils play a critical role in controlling infection and it is suggested that their migration and antimicrobial activity are impaired during sepsis which contribute to the dysregulation of immune responses. Recent studies further demonstrated that interruption or reversal of the impaired migration and antimicrobial function of neutrophils improves the outcome of sepsis in animal models. In this review, we provide an overview of the associated diagnostic biomarkers involved neutrophils in sepsis, and discuss the potential of neutrophils as a target to specifically predict the outcome of sepsis.
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Affiliation(s)
- Shu-Li Shao
- Department of Central Lab, Weihai Municipal Hospital Affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
| | - Hai-Yan Cong
- Department of Central Lab, Weihai Municipal Hospital Affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
| | - Ming-Yi Wang
- Department of Central Lab, Weihai Municipal Hospital Affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China.
| | - Peng Liu
- Department of Central Lab, Weihai Municipal Hospital Affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China.
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40
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Bourgoin P, Soliveres T, Ahriz D, Arnoux I, Meisel C, Unterwalder N, Morange PE, Michelet P, Malergue F, Markarian T. Clinical research assessment by flow cytometry of biomarkers for infectious stratification in an Emergency Department. Biomark Med 2019; 13:1373-1386. [PMID: 31617736 DOI: 10.2217/bmm-2019-0214] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: Management of patients with infections within the Emergency Department (ED) is challenging for practitioners, as the identification of infectious causes remains difficult with current techniques. A new combination of two biomarkers was tested with a new rapid flow cytometry technique. Materials & methods: Subjects from the ED were tested for their CD64 on neutrophils (nCD64) and CD169 on monocytes (mCD169) levels and results were compared to their clinical records. Results: Among 139 patients, 29% had confirmed bacterial infections and 5% viral infections. nCD64 and mCD169 respectively showed 88 and 86% sensitivity and 90 and 100% specificity for identifying subjects in bacterial or viral conditions. Conclusion: This point-of-care technique could allow better management of patients in the ED.
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Affiliation(s)
- Pénélope Bourgoin
- Department of Research & Development, Beckman Coulter Life Sciences-Immunotech, 130 Avenue de Lattre de Tassigny, 13009 Marseille, France.,C2VN Department, INSERM-INRA, Aix-Marseille University, 27 Boulevard Jean Moulin, 13385 Marseille, France
| | - Thomas Soliveres
- Adult Emergency Department, La Timone Hospital, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Dalia Ahriz
- Adult Emergency Department, La Timone Hospital, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Isabelle Arnoux
- Hematology Laboratory Department, La Timone Hospital, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Christian Meisel
- Department of Medical Immunology, Charité - University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.,Department of Immunology, Labor Berlin - Charité Vivantes GmbH, Sylter Strasse 2, 13353 Berlin, Germany
| | - Nadine Unterwalder
- Department of Immunology, Labor Berlin - Charité Vivantes GmbH, Sylter Strasse 2, 13353 Berlin, Germany
| | - Pierre-Emmanuel Morange
- C2VN Department, INSERM-INRA, Aix-Marseille University, 27 Boulevard Jean Moulin, 13385 Marseille, France.,Hematology Laboratory Department, La Timone Hospital, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Pierre Michelet
- Adult Emergency Department, La Timone Hospital, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Fabrice Malergue
- Department of Research & Development, Beckman Coulter Life Sciences-Immunotech, 130 Avenue de Lattre de Tassigny, 13009 Marseille, France
| | - Thibaut Markarian
- Adult Emergency Department, La Timone Hospital, 264 Rue Saint Pierre, 13385 Marseille, France
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41
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Hisert KB, Liles WC, Manicone AM. A Flow Cytometric Method for Isolating Cystic Fibrosis Airway Macrophages from Expectorated Sputum. Am J Respir Cell Mol Biol 2019; 61:42-50. [PMID: 30742539 PMCID: PMC6604218 DOI: 10.1165/rcmb.2018-0236ma] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/20/2018] [Indexed: 11/24/2022] Open
Abstract
Research to understand the contribution of macrophages to nonresolving airway inflammation in cystic fibrosis (CF) and other chronic suppurative airways diseases has been hindered by a lack of methods for isolating and studying these cells. With the development of technologies that can characterize small numbers of cells or individual cells, there is an even greater need for methodologies to isolate rare cells in heterogeneous specimens. Here, we describe a method that overcomes the technical obstacles imposed by sputum debris and apoptotic cells, and allows isolation of pure populations of macrophages from CF sputum. In addition to enhancing our ability to study human CF airway macrophages, this protocol can be adapted to study cells in sputum from other chronic suppurative lung diseases (e.g., chronic obstructive pulmonary disease) and used for isolation of individual cells for single cell analyses.
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Affiliation(s)
| | - W. Conrad Liles
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
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42
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Abstract
Biomarkers have become an integral part of the clinical decision-making process of clinicians dealing with febrile children. C-reactive protein, procalcitonin and white blood cell count are probably the most studied ones. Crucial to using biomarkers is the understanding of how a test result will alter post-test probabilities and then impact on clinical decision making. Improved analytical and computational platforms have enabled the next generation of advanced biomarker discovery studies. Promising combinations of candidate biomarkers for a diverse spectrum of febrile illnesses, such as viral and bacterial infections, have been identified using proteomics, RNA gene expression and metabolomics.
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43
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Biomarkers in Pneumonia-Beyond Procalcitonin. Int J Mol Sci 2019; 20:ijms20082004. [PMID: 31022834 PMCID: PMC6514895 DOI: 10.3390/ijms20082004] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/21/2019] [Accepted: 04/22/2019] [Indexed: 01/10/2023] Open
Abstract
Pneumonia is the leading infectious cause of mortality worldwide and one of the most common lower respiratory tract infections that is contributing significantly to the burden of antibiotic consumption. Due to the complexity of its pathophysiology, it is widely accepted that clinical diagnosis and prognosis are inadequate for the accurate assessment of the severity of the disease. The most challenging task for a physician is the risk stratification of patients with community-acquired pneumonia. Herein, early diagnosis is essential in order to reduce hospitalization and mortality. Procalcitonin and C-reactive protein remain the most widely used biomarkers, while interleukin 6 has been of particular interest in the literature. However, none of them appear to be ideal, and the search for novel biomarkers that will most sufficiently predict the severity and treatment response in pneumonia has lately intensified. Although our insight has significantly increased over the last years, a translational approach with the application of genomics, metabolomics, microbiomics, and proteomics is required to better understand the disease. In this review, we discuss this rapidly evolving area and summarize the application of novel biomarkers that appear to be promising for the accurate diagnosis and risk stratification of pneumonia.
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44
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Monneret G, Gossez M, Aghaeepour N, Gaudilliere B, Venet F. How Clinical Flow Cytometry Rebooted Sepsis Immunology. Cytometry A 2019; 95:431-441. [PMID: 30887636 DOI: 10.1002/cyto.a.23749] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/22/2019] [Accepted: 02/28/2019] [Indexed: 12/16/2022]
Abstract
On May 2017, the World Health Organization (WHO) recognized sepsis as a global health priority by adopting a resolution to improve the prevention, diagnosis, and management of this deadly disease. While it has long been known that sepsis deeply perturbs immune homeostasis by inducing a tremendous systemic inflammatory response, pivotal observations based on clinical flow cytometry indicate that sepsis indeed initiates a more complex immune response that varies over time, with the concomitant occurrence of both pro- and anti-inflammatory mechanisms. As a resultant, some septic patients enter a stage of protracted immunosuppression. This paved the way for immunostimulation approaches in sepsis. Clinical flow cytometry permitted this evolution by drawing a new picture of pathophysiology and reshaping immune trajectories in patients. Additional information from cytometry by time of flight mass cytometry and other high-dimensional flow cytometry platform should rapidly enrich our understanding of this complex disease. This review reports on landmarks of clinical flow cytometry in sepsis and how this single-cell analysis technique permitted to breach the wall of decades of unfruitful anti-inflammatory-based clinical trials in sepsis. © 2019 International Society for Advancement of Cytometry.
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Affiliation(s)
- Guillaume Monneret
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Laboratoire d'Immunologie, Lyon, 69003, France.,EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon 1, Hospices Civils de Lyon, BioMérieux, Hôpital Edouard Herriot, Lyon, France
| | - Morgane Gossez
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Laboratoire d'Immunologie, Lyon, 69003, France.,EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon 1, Hospices Civils de Lyon, BioMérieux, Hôpital Edouard Herriot, Lyon, France
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, 94121, USA
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, 94121, USA
| | - Fabienne Venet
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Laboratoire d'Immunologie, Lyon, 69003, France.,EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon 1, Hospices Civils de Lyon, BioMérieux, Hôpital Edouard Herriot, Lyon, France
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45
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Therrien A, Chapuy L, Bsat M, Rubio M, Bernard G, Arslanian E, Orlicka K, Weber A, Panzini BP, Dorais J, Bernard EJ, Soucy G, Bouin M, Sarfati M. Recruitment of activated neutrophils correlates with disease severity in adult Crohn's disease. Clin Exp Immunol 2018; 195:251-264. [PMID: 30347439 DOI: 10.1111/cei.13226] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2018] [Indexed: 12/17/2022] Open
Abstract
Neutrophils are detected in inflamed colon in Crohn's disease (CD). However, whether the frequency and/or activation of circulating or gut tissue neutrophils correlate with endoscopic severity remains to be investigated. A cohort of 73 CD patients was prospectively enrolled according to endoscopic severity and treatment history. Individuals with active disease were stratified using the Montreal classification. Harvey-Bradshaw Index (HBI) and Simple Endoscopic Score for Crohn's Disease (SES-CD) were performed at the time of ileocolonoscopy. Frequency of neutrophils and their expression of CD66b and CD64 were assessed in paired blood and colonic biopsies using flow cytometry. The percentage of neutrophils increased in inflamed colon and correlated with SES-CD in the entire cohort of patients examined, as well as in the subgroup with inflammatory (B1) active disease. SES-CD further correlated with neutrophil CD66b expression in mucosa but not blood and, conversely, with neutrophil CD64 expression in blood but not mucosa. However, the evaluation of neutrophil activation in mucosa when compared to blood reflected disease activity more clearly. Finally, a neutrophil activation power index (CD66b in mucosa X CD64 in blood) that correlated with SES-CD discriminated between patients with mild and severe disease. In conclusion, the frequency and activation of colonic neutrophils correlated with SES-CD, highlighting that mucosal neutrophils are associated with disease severity in CD.
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Affiliation(s)
- A Therrien
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - L Chapuy
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - M Bsat
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - M Rubio
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - G Bernard
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - E Arslanian
- Department of Pathology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - K Orlicka
- Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - A Weber
- Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - B-P Panzini
- Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - J Dorais
- Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - E-J Bernard
- Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - G Soucy
- Department of Pathology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - M Bouin
- Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - M Sarfati
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
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46
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Panneer Selvam A, Prasad S. Companion and Point-of-Care Sensor System for Rapid Multiplexed Detection of a Panel of Infectious Disease Markers. SLAS Technol 2018; 22:338-347. [PMID: 28520525 DOI: 10.1177/2211068217696779] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A nanochannel-based electrochemical biosensor has been demonstrated for rapid and multiplexed detection of a panel of three biomarkers associated with rapid detection of sepsis. The label-free biosensor detected procalcitonin (PCT), lipoteichoic acid (LTA), and lipopolysaccharide (LPS) from human whole blood. The biosensor comprises a nanoporous nylon membrane integrated onto a microelectrode sensor platform for nanoconfinement effects. Charge perturbations due to biomarker binding are recorded as impedance changes using electrochemical impedance spectroscopy. The measured impedance change is used to quantitatively determine the concentration of the three biomarkers using antibody receptors from the tested sample. We were successful in detecting and quantifying the three biomarkers from whole blood. The limit of detection was 0.1 ng/mL for PCT and 1 µg/mL for LPS and LTA. The sensor was able to demonstrate a dynamic range of detection from 01.1 ng/mL to 10 µg/mL for PCT and from 1 µg/mL to 1000 µg/mL for LPS and LTA biomarkers. This novel technology has promising preliminary results toward the design of sensors for rapid and sensitive detection of the three panel biomarkers in whole blood toward diagnosis and classification of sepsis.
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Affiliation(s)
- Anjan Panneer Selvam
- 1 Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - Shalini Prasad
- 1 Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
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47
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Mortaz E, Alipoor SD, Adcock IM, Mumby S, Koenderman L. Update on Neutrophil Function in Severe Inflammation. Front Immunol 2018; 9:2171. [PMID: 30356867 PMCID: PMC6190891 DOI: 10.3389/fimmu.2018.02171] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 09/03/2018] [Indexed: 12/17/2022] Open
Abstract
Neutrophils are main players in the effector phase of the host defense against micro-organisms and have a major role in the innate immune response. Neutrophils show phenotypic heterogeneity and functional flexibility, which highlight their importance in regulation of immune function. However, neutrophils can play a dual role and besides their antimicrobial function, deregulation of neutrophils and their hyperactivity can lead to tissue damage in severe inflammation or trauma. Neutrophils also have an important role in the modulation of the immune system in response to severe injury and trauma. In this review we will provide an overview of the current understanding of neutrophil subpopulations and their function during and post-infection and discuss the possible mechanisms of immune modulation by neutrophils in severe inflammation.
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Affiliation(s)
- Esmaeil Mortaz
- Department of Immunology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shamila D Alipoor
- Molecular Medicine Department, Institute of Medical Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Ian M Adcock
- Priority Research Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.,Airways Disease Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sharon Mumby
- Airways Disease Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Leo Koenderman
- Laboratory of Translational Immunology, Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, Netherlands
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48
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Examining the utility of the CD64 index compared with other conventional indices for early diagnosis of neonatal infection. Sci Rep 2018; 8:9994. [PMID: 29968788 PMCID: PMC6030194 DOI: 10.1038/s41598-018-28352-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 06/20/2018] [Indexed: 02/08/2023] Open
Abstract
As specific clinical manifestations and detection tools for early neonatal infections are lacking, early detection and treatment are ongoing challenges. The present study aimed to investigate the role and clinical significance of the CD64 index in comparison with conventional examination indices (WBC, PCT and CRP) for the early diagnosis of neonatal infection. Of 74 in-patient newborns, non-sepsis (non-specific infection but free of sepsis), sepsis and control [newborns with ABO hemolytic disease of the newborn (ABOHDN) but without infection] groups involved 32, 16 and 26 cases, respectively. Peripheral blood WBC, PCT, CRP and CD64 indices were acquired for all groups. The sepsis group showed significantly higher WBC, PCT and CRP levels than the control group. Compared with the non-sepsis group, the sepsis group demonstrated significant increases in PCT but not in WBC or CRP. Compared with the control group, the non-sepsis and sepsis groups had higher CD64 indices. Combined, compared with the WBC, PCT and CRP indices, the CD64 index is unique in its capacity to diagnose neonatal infections early. The CD64 index combined with other conventional indices may lay a basis for the future early diagnosis and effective treatment of neonatal infections.
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49
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Nancy Hilda J, Das S. Neutrophil CD64, TLR2 and TLR4 expression increases but phagocytic potential decreases during tuberculosis. Tuberculosis (Edinb) 2018; 111:135-142. [DOI: 10.1016/j.tube.2018.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/04/2018] [Accepted: 06/07/2018] [Indexed: 12/01/2022]
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50
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Zhang M, Yang L, Du G, Duan S, Liu D, Gao X, Li D. Early diagnosis of infection occurs in burned patients and verification in vitro. Int J Lab Hematol 2018; 40:448-452. [PMID: 29575661 DOI: 10.1111/ijlh.12810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 02/06/2018] [Indexed: 11/27/2022]
Affiliation(s)
- M. Zhang
- First Affiliated Hospital of Guangxi Medical University; Nanning Guangxi China
| | - L. Yang
- First Affiliated Hospital of Guangxi Medical University; Nanning Guangxi China
- First Affiliated Hospital of Guangxi University of Chinese Medicine; Nanning Guangxi China
| | - G. Du
- First Affiliated Hospital of Guangxi Medical University; Nanning Guangxi China
| | - S. Duan
- Medical College of Guangxi University of Science and Technology; Liuzhou Guangxi China
| | - D. Liu
- First Affiliated Hospital of Guangxi Medical University; Nanning Guangxi China
| | - X. Gao
- First Affiliated Hospital of Guangxi Medical University; Nanning Guangxi China
| | - D. Li
- First Affiliated Hospital of Guangxi Medical University; Nanning Guangxi China
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