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Singh P, Gadgeel M, AlQanber B, Farooqi A, Savaşan S. Flow Cytometry as the Tool to Define Peripheral Blood Leukocyte Signatures in Acute EBV Infection. Cells 2024; 13:963. [PMID: 38891094 PMCID: PMC11171800 DOI: 10.3390/cells13110963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Primary Epstein-Barr virus (EBV) infection which can manifest as infectious mononucleosis (IM) is commonly acquired during childhood. EBV primarily invades B cells leading to a lytic reaction; the control of the infection is handled by natural killer and T cells in immunocompetent individuals. The infection has a wide spectrum of clinical findings and can lead to serious complications in patients with certain underlying immunological dysfunctions. We retrospectively investigated peripheral white blood cell populations' surface marker characteristics in IM using a comprehensive flow cytometry marker panel. Twenty-one cases of IM and seventeen EBV-seropositive cases without IM serving as controls were included. We observed novel alterations in lymphocyte, neutrophil, and monocyte populations. In addition to increased activated cytotoxic T cells and low B cells, we demonstrated high T-large granular lymphocyte (T-LGL) populations in IM cases. Furthermore, despite T cells' increased HLA-DR expression, another activation marker, CD11b, was lower in T-LGL populations. Monocytes showed increased CD16 expression; CD64 was higher in neutrophils. Our findings point to monocyte and neutrophil activation which may account for acute clinical features and may contribute to the understanding of IM immunobiology. Furthermore, they may serve as a useful tool in investigating inherited and post-transplant conditions characterized by deficiencies in controlling EBV infection.
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Affiliation(s)
- Pragya Singh
- Children’s Hospital of Michigan, Detroit, MI 48201, USA;
| | - Manisha Gadgeel
- Hematology/Oncology Flow Cytometry Laboratory, Division of Hematology/Oncology, Children’s Hospital of Michigan, Detroit, MI 48201, USA; (M.G.); (B.A.)
| | - Batool AlQanber
- Hematology/Oncology Flow Cytometry Laboratory, Division of Hematology/Oncology, Children’s Hospital of Michigan, Detroit, MI 48201, USA; (M.G.); (B.A.)
- Department of Pediatrics, Central Michigan University College of Medicine, Saginaw, MI 48602, USA;
| | - Ahmad Farooqi
- Department of Pediatrics, Central Michigan University College of Medicine, Saginaw, MI 48602, USA;
| | - Süreyya Savaşan
- Hematology/Oncology Flow Cytometry Laboratory, Division of Hematology/Oncology, Children’s Hospital of Michigan, Detroit, MI 48201, USA; (M.G.); (B.A.)
- Department of Pediatrics, Central Michigan University College of Medicine, Saginaw, MI 48602, USA;
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
- Barbara Ann Karmanos Cancer Center, Division of Hematology/Oncology, Pediatric Blood and Marrow Transplant Program, Children’s Hospital of Michigan, Detroit, MI 48201, USA
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Fu D, Gao S, Li JN, Cui YH, Luo YW, Zhong YJ, Li Q, Luo C, Dai RP, Luo RY, Hu ZL. P75 NTR+CD64 + neutrophils promote sepsis-induced acute lung injury. Clin Immunol 2024; 263:110206. [PMID: 38599263 DOI: 10.1016/j.clim.2024.110206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/24/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
Patients suffering from sepsis-induced acute lung injury (ALI) exhibit a high mortality rate, and their prognosis is closely associated with infiltration of neutrophils into the lungs. In this study, we found a significant elevation of CD64+ neutrophils, which highly expressed p75 neurotrophin receptor (p75NTR) in peripheral blood of mice and patients with sepsis-induced ALI. p75NTR+CD64+ neutrophils were also abundantly expressed in the lung of ALI mice induced by lipopolysaccharide. Conditional knock-out of the myeloid lineage's p75NTR gene improved the survival rates, attenuated lung tissue inflammation, reduced neutrophil infiltration and enhanced the phagocytic functions of CD64+ neutrophils. In vitro, p75NTR+CD64+ neutrophils exhibited an upregulation and compromised phagocytic activity in blood samples of ALI patients. Blocking p75NTR activity by soluble p75NTR extracellular domain peptide (p75ECD-Fc) boosted CD64+ neutrophils phagocytic activity and reduced inflammatory cytokine production via regulation of the NF-κB activity. The findings strongly indicate that p75NTR+CD64+ neutrophils are a novel pathogenic neutrophil subpopulation promoting sepsis-induced ALI.
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Affiliation(s)
- Di Fu
- Department of Anesthesiology, The Xiangya Hospital, Central South University, Changsha City, Hunan 410008, China
| | - Shan Gao
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Jia-Nan Li
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Yan-Hui Cui
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha City, Hunan 410011, China
| | - Yan-Wei Luo
- Department of Blood Transfusion, The Third Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Yan-Jun Zhong
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiao Li
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Cong Luo
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Ru-Ping Dai
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China
| | - Ru-Yi Luo
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China.
| | - Zhao-Lan Hu
- Anesthesia Medical Research Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan 410011, China.
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3
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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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Santacroce E, D'Angerio M, Ciobanu AL, Masini L, Lo Tartaro D, Coloretti I, Busani S, Rubio I, Meschiari M, Franceschini E, Mussini C, Girardis M, Gibellini L, Cossarizza A, De Biasi S. Advances and Challenges in Sepsis Management: Modern Tools and Future Directions. Cells 2024; 13:439. [PMID: 38474403 DOI: 10.3390/cells13050439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
Sepsis, a critical condition marked by systemic inflammation, profoundly impacts both innate and adaptive immunity, often resulting in lymphopenia. This immune alteration can spare regulatory T cells (Tregs) but significantly affects other lymphocyte subsets, leading to diminished effector functions, altered cytokine profiles, and metabolic changes. The complexity of sepsis stems not only from its pathophysiology but also from the heterogeneity of patient responses, posing significant challenges in developing universally effective therapies. This review emphasizes the importance of phenotyping in sepsis to enhance patient-specific diagnostic and therapeutic strategies. Phenotyping immune cells, which categorizes patients based on clinical and immunological characteristics, is pivotal for tailoring treatment approaches. Flow cytometry emerges as a crucial tool in this endeavor, offering rapid, low cost and detailed analysis of immune cell populations and their functional states. Indeed, this technology facilitates the understanding of immune dysfunctions in sepsis and contributes to the identification of novel biomarkers. Our review underscores the potential of integrating flow cytometry with omics data, machine learning and clinical observations to refine sepsis management, highlighting the shift towards personalized medicine in critical care. This approach could lead to more precise interventions, improving outcomes in this heterogeneously affected patient population.
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Affiliation(s)
- Elena Santacroce
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Miriam D'Angerio
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Alin Liviu Ciobanu
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Linda Masini
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Domenico Lo Tartaro
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Irene Coloretti
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stefano Busani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Ignacio Rubio
- Department of Anesthesiology and Intensive Care Medicine, Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany
| | - Marianna Meschiari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Erica Franceschini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Cristina Mussini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Massimo Girardis
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Lara Gibellini
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Andrea Cossarizza
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Sara De Biasi
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Li Y, Zhang J, Wang S, Cao J. Diagnostic and Prognostic Value of Peripheral Neutrophil CD64 Index in Elderly Patients with Community-Acquired Pneumonia. Crit Rev Immunol 2024; 44:79-89. [PMID: 38505923 DOI: 10.1615/critrevimmunol.2024050769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality in the elderly. The peripheral blood neutrophil CD64 (nCD64) index is increasingly recognized for its association with poor pneumonia prognosis. A comprehensive investigation involving 128 elderly patients diagnosed with CAP, including 96 with non-severe CAP and 32 with severe CAP, from January 2020 to January 2021 was performed. The nCD64 index, CD4+, CD8+, C-reactive protein (CRP), white blood cell (WBC) count, procalcitonin (PCT), neutrophil (NEUT), and B lymphocyte count were determined using flow cytometry. Our findings reveal that patients with severe CAP exhibited significantly higher levels of nCD64 index, NEUT, WBC, CRP, and PCT. Intriguingly, lower CRP, nCD64 index, CURB-65 score, and PCT were associated with a higher survival rate. Notably, the nCD64 index demonstrated remarkable predictive efficiency for 28-d survival in CAP patients [area under the curve (AUC) = 0.907], surpassing other markers and even showing enhanced predictive power when combined with the CURB-65 score (AUC = 0.905). Furthermore, a negative association was observed between the nCD64 index and both CD4+, CD4+/CD8+ ratios, and B lymphocytes, highlighting its potential role in immune dysregulation. These findings underscore the critical importance of the nCD64 index in the early diagnosis, risk stratification, and prognostic evaluation of infections and immune responses in elderly CAP patients.
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Affiliation(s)
- Yan Li
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jing Zhang
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Suhang Wang
- Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jie Cao
- Tianjin Medical University General Hospital
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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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Dimitrov E, Halacheva K, Minkov G, Enchev E, Yovtchev Y. Prognostic performance of neutrophil CD64 expression in patients with complicated intra-abdominal infections - a prospective study. Scand J Clin Lab Invest 2023; 83:323-329. [PMID: 37352378 DOI: 10.1080/00365513.2023.2225221] [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: 12/18/2022] [Revised: 05/23/2023] [Accepted: 06/11/2023] [Indexed: 06/25/2023]
Abstract
No study yet analyzed the prognostic abilities of neutrophil CD64 expression (nCD64) in complicated intra-abdominal infections (cIAIs), therefore our aim was to evaluate the possible association between this biomarker and outcome in such patients. This single-center prospective study was conducted in the Department of Surgical Diseases at a University Hospital 'Prof. Dr. Stoyan Kirkovich' Stara Zagora for the period November 2018 - August 2021. We used flow cytometry to measure the percentage of nCD64 preoperatively and on the 3rd postoperative day (POD) in 62 patients with cIAIs and 31 healthy controls. Of the 62 enrolled patients, nine (14.5%) died during hospitalization. The perioperative expression of nCD64 was significantly higher in non-survivors compared to survivors (p = 0.02 before surgery and p = 0.024 after surgery). ROC Curve analysis revealed the good prognostic value of pre- and postoperative nCD64 levels as mortality predictors (AUROC = 0.744 and 0.765, respectively). Preoperatively, the identified sensitivity and specificity for nCD64 cut-off = 94.8% were 66.7% and 84.6%, respectively and on the 3rd POD for nCD64 cut-off = 84.85% we observed a sensitivity of 71.4% and a specificity of 78.8%. Neutrophil CD64 shows good prognostic value in patients with cIAIs both preoperatively and on the 3rd POD.
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Affiliation(s)
- Evgeni Dimitrov
- Department of Surgical Diseases, University Hospital 'Prof. Dr. Stoyan Kirkovich' Stara Zagora, Bulgaria
- Department of Surgical Diseases and Anesthesiology, Faculty of Medicine, Trakia University Stara Zagora, Bulgaria
| | | | - Georgi Minkov
- Department of Surgical Diseases, University Hospital 'Prof. Dr. Stoyan Kirkovich' Stara Zagora, Bulgaria
- Department of Surgical Diseases and Anesthesiology, Faculty of Medicine, Trakia University Stara Zagora, Bulgaria
| | - Emil Enchev
- Department of Surgical Diseases, University Hospital 'Prof. Dr. Stoyan Kirkovich' Stara Zagora, Bulgaria
- Department of Surgical Diseases and Anesthesiology, Faculty of Medicine, Trakia University Stara Zagora, Bulgaria
| | - Yovcho Yovtchev
- Department of Surgical Diseases, University Hospital 'Prof. Dr. Stoyan Kirkovich' Stara Zagora, Bulgaria
- Department of Surgical Diseases and Anesthesiology, Faculty of Medicine, Trakia University Stara Zagora, Bulgaria
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Yin P, Fan Y, Dong W, Shao S, Zhu J, Zhu X, Shi H. The Value of CD64 in the Early Diagnosis for Intracranial Infection After Craniocerebral Surgery. World Neurosurg 2023; 176:e1-e7. [PMID: 36347464 DOI: 10.1016/j.wneu.2022.11.007] [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: 10/13/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To investigate the value of CD64 in the early diagnosis of intracranial infection after craniocerebral surgery. METHODS A total of 93 patients who met the inclusion and exclusion criteria after neurosurgery in Lianyungang First People's Hospital and Lianyungang Second People's Hospital were admitted and divided into experimental group with intracranial infection (n = 32) and uninfected control group (n = 61) according to the results of cerebrospinal fluid culture. We performed relevant statistical analysis, drew the receiver operating characteristic curve and calculated area under the curve (AUC). RESULTS The sensitivity and specificity of the CD64, c-reactive protein (CRP), and white blood cell (WBC) counts were 84.38% and 86.89%, 78.13% and 75.41%, and 75.00% and 67.21%, respectively; the AUCs were 0.912, 0.858, and 0.851, respectively. Accuracy was the highest when the 3 diagnosis were combined, reaching 93.75%; the AUC could reach 0.948. CONCLUSIONS Serum CD64, CRP, and WBC count in the diagnosis of intracranial infection after craniocerebral surgery were significant. CD64 was more valuable than the others. The diagnostic efficiency could be improved when CD64, CRP, and WBC count were combined.
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Affiliation(s)
- Peng Yin
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China
| | - Yongjun Fan
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China
| | - Wensheng Dong
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China
| | - Shike Shao
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China
| | - Jiaqiu Zhu
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China
| | - Xianlong Zhu
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China
| | - Hui Shi
- Department of Neurosurgery, Lianyungang Second People's Hospital, Bengbu Medical College, Jiangsu, China.
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Miyajima Y, Niimi H, Ueno T, Matsui A, Higashi Y, Kojima N, Kono M, Iwasaki Y, Nagaoka K, Yamamoto Y, Kitajima I. Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia. Front Med (Lausanne) 2023; 10:1156889. [PMID: 37324133 PMCID: PMC10267328 DOI: 10.3389/fmed.2023.1156889] [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: 02/02/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
Background Cell population data (CPD) parameters related to neutrophils, such as fluorescent light intensity (NE-SFL) and fluorescent light distribution width index (NE-WY), have emerged as potential biomarkers for sepsis. However, the diagnostic implication in acute bacterial infection remains unclear. This study assessed the diagnostic value of NE-WY and NE-SFL for bacteremia in patients with acute bacterial infections, and those associations with other sepsis biomarkers. Methods Patients with acute bacterial infections were enrolled in this prospective observational cohort study. For all patients, a blood sample, with at least two sets of blood cultures, were collected at the onset of infection. Microbiological evaluation included examination of the blood bacterial load using PCR. CPD was assessed using Automated Hematology analyzer Sysmex series XN-2000. Serum levels of procalcitonin (PCT), interleukin-6 (IL-6), presepsin, and CRP were also assessed. Results Of 93 patients with acute bacterial infection, 24 developed culture-proven bacteremia and 69 did not. NE-SFL and NE-WY were significantly higher in patients with bacteremia than in those without bacteremia (p < 0.005, respectively), and were significantly correlated with the bacterial load determined by PCR (r = 0.384 and r = 0.374, p < 0.005, respectively). To assess the diagnostic value for bacteremia, receiver operating characteristic curve analysis was used. NE-SFL and NE-WY showed an area under the curve of 0.685 and 0.708, respectively, while those of PCT, IL-6, presepsin, and CRP were 0.744, 0.778, 0.685, and 0.528, respectively. Correlation analysis showed that the levels of NE-WY and NE-SFL were strongly correlated with PCT and IL-6 levels. Conclusion This study demonstrated that NE-WY and NE-SFL could predict bacteremia in a manner that may be different from that of other indicators. These findings suggest there are potential benefits of NE-WY/NE-SFL in predicting severe bacterial infections.
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Affiliation(s)
- Yuki Miyajima
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Hideki Niimi
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
| | - Tomohiro Ueno
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
| | - Atsushi Matsui
- First Department of Internal Medicine, Toyama University Hospital, Toyama, Japan
| | - Yoshitsugu Higashi
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Nozomi Kojima
- Gene Technology Group, Reagent Engineering, Sysmex Corporation, Hyogo, Japan
| | - Mari Kono
- R&D Center Asia Pacific, Sysmex Asia Pacific Pte Ltd, Singapore, Singapore
| | - Yosuke Iwasaki
- Scientific Research, Scientific Affairs, Sysmex Corporation, Hyogo, Japan
| | - Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Isao Kitajima
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
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10
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Wu W, Zhang D, Jin T, Lu T, Zhou F. Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy. Front Immunol 2023; 14:1142346. [PMID: 37063849 PMCID: PMC10097887 DOI: 10.3389/fimmu.2023.1142346] [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: 01/12/2023] [Accepted: 03/22/2023] [Indexed: 04/01/2023] Open
Abstract
Urolithiasis is a common and frequent disease in urology. Percutaneous nephrolithotomy (PCNL) is preferred for the treatment of upper urinary tract stones and complicated renal stones >2 cm in diameter, but it has a higher rate of postoperative complications, especially infection, compared with other minimally invasive treatments for urinary stones. Complications associated with infection after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome (SIRS), and sepsis, which is considered one of the most common causes of perioperative death after percutaneous nephrolithotomy. In contrast, SIRS serves as a sentinel for sepsis, so early intervention of SIRS by biomarker identification can reduce the incidence of postoperative sepsis, which in turn reduces the length of stay and hospital costs for patients. In this paper, we summarize traditional inflammatory indicators, novel inflammatory indicators, composite inflammatory indicators and other biomarkers for early identification of systemic inflammatory response syndrome after percutaneous nephrolithotomy.
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Affiliation(s)
- Wangjian Wu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Di Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
| | - Tongtong Jin
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Tianyi Lu
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
| | - Fenghai Zhou
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- Department of Urology, Gansu Provincial Hospital, Lanzhou, China
- *Correspondence: Fenghai Zhou,
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11
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Bruserud Ø, Mosevoll KA, Bruserud Ø, Reikvam H, Wendelbo Ø. The Regulation of Neutrophil Migration in Patients with Sepsis: The Complexity of the Molecular Mechanisms and Their Modulation in Sepsis and the Heterogeneity of Sepsis Patients. Cells 2023; 12:cells12071003. [PMID: 37048076 PMCID: PMC10093057 DOI: 10.3390/cells12071003] [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: 02/01/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Common causes include gram-negative and gram-positive bacteria as well as fungi. Neutrophils are among the first cells to arrive at an infection site where they function as important effector cells of the innate immune system and as regulators of the host immune response. The regulation of neutrophil migration is therefore important both for the infection-directed host response and for the development of organ dysfunctions in sepsis. Downregulation of CXCR4/CXCL12 stimulates neutrophil migration from the bone marrow. This is followed by transmigration/extravasation across the endothelial cell barrier at the infection site; this process is directed by adhesion molecules and various chemotactic gradients created by chemotactic cytokines, lipid mediators, bacterial peptides, and peptides from damaged cells. These mechanisms of neutrophil migration are modulated by sepsis, leading to reduced neutrophil migration and even reversed migration that contributes to distant organ failure. The sepsis-induced modulation seems to differ between neutrophil subsets. Furthermore, sepsis patients should be regarded as heterogeneous because neutrophil migration will possibly be further modulated by the infecting microorganisms, antimicrobial treatment, patient age/frailty/sex, other diseases (e.g., hematological malignancies and stem cell transplantation), and the metabolic status. The present review describes molecular mechanisms involved in the regulation of neutrophil migration; how these mechanisms are altered during sepsis; and how bacteria/fungi, antimicrobial treatment, and aging/frailty/comorbidity influence the regulation of neutrophil migration.
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Affiliation(s)
- Øystein Bruserud
- Leukemia Research Group, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Correspondence:
| | - Knut Anders Mosevoll
- Section for Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Section for Infectious Diseases, Department of Clinical Research, University of Bergen, 5021 Bergen, Norway
| | - Øyvind Bruserud
- Department for Anesthesiology and Intensive Care, Haukeland University Hospital, 5021 Bergen, Norway
| | - Håkon Reikvam
- Leukemia Research Group, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Øystein Wendelbo
- Section for Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Faculty of Health, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway
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12
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Obraztsov IV, Zhirkova YV, Chernikova EV, Krapivkin AI, Brunova OY, Abdraisova AT, Davydova NV. Feasibility of phagocytes functional testing in neonatal sepsis diagnostics. ROSSIYSKIY VESTNIK PERINATOLOGII I PEDIATRII (RUSSIAN BULLETIN OF PERINATOLOGY AND PEDIATRICS) 2023. [DOI: 10.21508/1027-4065-2023-68-1-24-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Neonatal sepsis is a problem still relevant for healthcare in Russia and worldwide due to high mortality and resistance to treatment. Generalization of infection in newborns occurs because of innate immunity deficiency that particularly leads to neutrophil and monocyte malfunction. Nowadays clinical practice of neonatal sepsis diagnostics does not include phagocytes functional testing. Purpose. The study aims at evaluating the ability of sepsis biomarkers (CRP, PCT, lactate, CD64, CD16, HLA-DR) to differentiate the pathogenesis of organ dysfunction in newborns in the ICU setting.Material and methods. We assessed the surface expression of neutrophil CD64 and CD16, as well as monocytic HLA-DR in newborn ICU patients with different genesis of multiple organ failure — sepsis, asphyxia and combined; as well as different outcomes of hospitalization in the ICU — survivors and deaths.Results. We have shown a significant increase in the neutrophil CD64 expression and a decrease in the monocytic HLA-DR in infectious and combined genesis of multiple organ failure compared with severe asphyxia; deaths were associated with reduced expression of neutrophil CD16.Conclusion. Our data could substantiate combined use of the phagocytes functional testing indicators together with conventional sepsis biomarkers in order to increase their prognostic and predictive value.
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Affiliation(s)
| | - Yu. V. Zhirkova
- Speranskiy City Children Hospital; Pirogov Russian National Research Medical University
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13
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Porwit A, Béné MC, Duetz C, Matarraz S, Oelschlaegel U, Westers TM, Wagner-Ballon O, Kordasti S, Valent P, Preijers F, Alhan C, Bellos F, Bettelheim P, Burbury K, Chapuis N, Cremers E, Della Porta MG, Dunlop A, Eidenschink-Brodersen L, Font P, Fontenay M, Hobo W, Ireland R, Johansson U, Loken MR, Ogata K, Orfao A, Psarra K, Saft L, Subira D, Te Marvelde J, Wells DA, van der Velden VHJ, Kern W, van de Loosdrecht AA. Multiparameter flow cytometry in the evaluation of myelodysplasia: Analytical issues: Recommendations from the European LeukemiaNet/International Myelodysplastic Syndrome Flow Cytometry Working Group. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2023; 104:27-50. [PMID: 36537621 PMCID: PMC10107708 DOI: 10.1002/cyto.b.22108] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/20/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023]
Abstract
Multiparameter flow cytometry (MFC) is one of the essential ancillary methods in bone marrow (BM) investigation of patients with cytopenia and suspected myelodysplastic syndrome (MDS). MFC can also be applied in the follow-up of MDS patients undergoing treatment. This document summarizes recommendations from the International/European Leukemia Net Working Group for Flow Cytometry in Myelodysplastic Syndromes (ELN iMDS Flow) on the analytical issues in MFC for the diagnostic work-up of MDS. Recommendations for the analysis of several BM cell subsets such as myeloid precursors, maturing granulocytic and monocytic components and erythropoiesis are given. A core set of 17 markers identified as independently related to a cytomorphologic diagnosis of myelodysplasia is suggested as mandatory for MFC evaluation of BM in a patient with cytopenia. A myeloid precursor cell (CD34+ CD19- ) count >3% should be considered immunophenotypically indicative of myelodysplasia. However, MFC results should always be evaluated as part of an integrated hematopathology work-up. Looking forward, several machine-learning-based analytical tools of interest should be applied in parallel to conventional analytical methods to investigate their usefulness in integrated diagnostics, risk stratification, and potentially even in the evaluation of response to therapy, based on MFC data. In addition, compiling large uniform datasets is desirable, as most of the machine-learning-based methods tend to perform better with larger numbers of investigated samples, especially in such a heterogeneous disease as MDS.
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Affiliation(s)
- Anna Porwit
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, CRCINA Inserm 1232, Nantes, France
| | - Carolien Duetz
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Sergio Matarraz
- Cancer Research Center (IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Uta Oelschlaegel
- Department of Internal Medicine, University Hospital Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Theresia M Westers
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Orianne Wagner-Ballon
- Department of Hematology and Immunology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France
- Inserm U955, Université Paris-Est Créteil, Créteil, France
| | | | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Frank Preijers
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Canan Alhan
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Peter Bettelheim
- Department of Hematology, Ordensklinikum Linz, Elisabethinen, Linz, Austria
| | - Kate Burbury
- Department of Haematology, Peter MacCallum Cancer Centre, & University of Melbourne, Melbourne, Australia
| | - Nicolas Chapuis
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Cochin Hospital, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Université de Paris, Paris, France
| | - Eline Cremers
- Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Matteo G Della Porta
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alan Dunlop
- Department of Haemato-Oncology, Royal Marsden Hospital, London, UK
| | | | - Patricia Font
- Department of Hematology, Hospital General Universitario Gregorio Marañon-IiSGM, Madrid, Spain
| | - Michaela Fontenay
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Cochin Hospital, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Université de Paris, Paris, France
| | - Willemijn Hobo
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Robin Ireland
- Department of Haematology and SE-HMDS, King's College Hospital NHS Foundation Trust, London, UK
| | - Ulrika Johansson
- Laboratory Medicine, SI-HMDS, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Kiyoyuki Ogata
- Metropolitan Research and Treatment Centre for Blood Disorders (MRTC Japan), Tokyo, Japan
| | - Alberto Orfao
- Cancer Research Center (IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Katherina Psarra
- Department of Immunology - Histocompatibility, Evangelismos Hospital, Athens, Greece
| | - Leonie Saft
- Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital and Institute Solna, Stockholm, Sweden
| | - Dolores Subira
- Department of Hematology, Flow Cytometry Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Jeroen Te Marvelde
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Vincent H J van der Velden
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Arjan A van de Loosdrecht
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
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14
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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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15
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Bonini A, Carota AG, Poma N, Vivaldi FM, Biagini D, Bottai D, Lenzi A, Tavanti A, Di Francesco F, Lomonaco T. Emerging Biosensing Technologies towards Early Sepsis Diagnosis and Management. BIOSENSORS 2022; 12:894. [PMID: 36291031 PMCID: PMC9599348 DOI: 10.3390/bios12100894] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Sepsis is defined as a systemic inflammatory dysfunction strictly associated with infectious diseases, which represents an important health issue whose incidence is continuously increasing worldwide. Nowadays, sepsis is considered as one of the main causes of death that mainly affects critically ill patients in clinical settings, with a higher prevalence in low-income countries. Currently, sepsis management still represents an important challenge, since the use of traditional techniques for the diagnosis does not provide a rapid response, which is crucial for an effective infection management. Biosensing systems represent a valid alternative due to their characteristics such as low cost, portability, low response time, ease of use and suitability for point of care/need applications. This review provides an overview of the infectious agents associated with the development of sepsis and the host biomarkers suitable for diagnosis and prognosis. Special focus is given to the new emerging biosensing technologies using electrochemical and optical transduction techniques for sepsis diagnosis and management.
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Affiliation(s)
- Andrea Bonini
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
- Department of Biology, University of Pisa, Via San Zeno 35-39, 56100 Pisa, Italy
| | - Angela Gilda Carota
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Noemi Poma
- Department of Biology, University of Pisa, Via San Zeno 35-39, 56100 Pisa, Italy
| | - Federico Maria Vivaldi
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Denise Biagini
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Daria Bottai
- Department of Biology, University of Pisa, Via San Zeno 35-39, 56100 Pisa, Italy
| | - Alessio Lenzi
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Arianna Tavanti
- Department of Biology, University of Pisa, Via San Zeno 35-39, 56100 Pisa, Italy
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
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16
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Huang Z, Zhang H, Fu X, Han L, Zhang H, Zhang L, Zhao J, Xiao D, Li H, Li P. Autophagy-driven neutrophil extracellular traps: The dawn of sepsis. Pathol Res Pract 2022; 234:153896. [PMID: 35462228 DOI: 10.1016/j.prp.2022.153896] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/28/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022]
Abstract
Sepsis is a systemic inflammatory syndrome caused by infection disorders. The core mechanism of sepsis is immune dysfunction. Neutrophils are the most abundant circulating white blood cells, which play a crucial role in mediating the innate immune response. Previous studies have shown that an effective way to treat sepsis is through the regulation of neutrophil functions. Autophagy, a highly conserved degradation process, is responsible for removing denatured proteins or damaged organelles within cells and protecting cells from external stimuli. It is a key homeostasis process that promotes neutrophil function and differentiation. Autophagy has been shown to be closely associated with inflammation and immunity. Neutrophils, the first line of innate immunity, migrate to inflammatory sites upon their activation. Neutrophil-mediated autophagy may participate in the clinical course of sepsis. In this review, we summarized and analyzed the latest research findings on the changes in neutrophil external traps during sepsis, the regulatory role of autophagy in neutrophil, and the potential application of autophagy-driven NETs in sepsis, so as to guide clinical treatment of sepsis.
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Affiliation(s)
- Zhenzhen Huang
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Haodong Zhang
- Department of Hypertension Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Xu Fu
- Key Laboratory of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Li Han
- Key Laboratory of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Haidan Zhang
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Ling Zhang
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Zhao
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Danyang Xiao
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Hongyao Li
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China
| | - Peiwu Li
- Department of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou, China.
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17
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Zhou J, Xu W, Wang J, Fan Z. Related Markers for the Precision Diagnosis of Complex Appendicitis in Children. Front Pharmacol 2022; 13:865303. [PMID: 35431963 PMCID: PMC9010144 DOI: 10.3389/fphar.2022.865303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Acute appendicitis is the most common surgical emergency in children. Despite the high incidence rate of appendicitis, it is sometimes misdiagnosed or missed. Complex appendicitis (CA) in children is characterized by a critical condition, several complications, and high mortality. Precision distinguishing between simple appendicitis and CA correctly is key to choosing appropriate treatment. A safe, cheap, rapid, extensive and accurate diagnostic marker of appendicitis will be of great significance for emergency general surgeons to treat suspected CA. Many studies have investigated possible diagnostic markers for the diagnosis of CA in children. In this study, studies related to CA in children in recent years are summarized, and the related markers and scoring system for the diagnosis of CA in children are summarized.
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Affiliation(s)
- Jialin Zhou
- Department of General Surgery, The Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
- Department of Central Laboratory, The Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Wenjing Xu
- Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jitao Wang
- Department of Hepatobiliary Surgery, Xingtai People’s Hospital, Xingtai, China
- *Correspondence: Jitao Wang, ; Zhe Fan,
| | - Zhe Fan
- Department of General Surgery, The Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
- Department of Central Laboratory, The Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
- *Correspondence: Jitao Wang, ; Zhe Fan,
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18
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Shang YX, Zheng Z, Wang M, Guo HX, Chen YJ, Wu Y, Li X, Li Q, Cui JY, Ren XX, Wang LR. Diagnostic performance of Neutrophil CD64 index, procalcitonin, and C-reactive protein for early sepsis in hematological patients. World J Clin Cases 2022; 10:2127-2137. [PMID: 35321184 PMCID: PMC8895178 DOI: 10.12998/wjcc.v10.i7.2127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/17/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with hematological diseases are immunosuppressed due to various factors, including the disease itself and treatments, such as chemotherapy and immunotherapy, and are susceptible to infection. Infections in these patients often progress rapidly to sepsis, which is life-threatening.
AIM To evaluate the diagnostic efficacy of the neutrophil CD64 (nCD64) index, compared to procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP), for the identification of early sepsis in patients with hematological diseases.
METHODS This was a prospective analysis of patients with hematological diseases treated at the Fuxing Hospital affiliated with Capital Medical University, between March 2014 and December 2018. The nCD64 index was quantified by flow cytometry and the Leuko64 assay software. The factors which may affect the nCD64 index levels were compared between patients with different infection statuses (local infection, sepsis, and no infection), and the control group and the nCD64 index levels were compared among the groups. The diagnostic efficacy of the nCD64 index, PCT, and hs-CRP for early sepsis was evaluated among patients with hematological diseases.
RESULTS A total of 207 patients with hematological diseases (non-infected group, n = 50; locally infected group, n = 67; sepsis group, n = 90) and 26 healthy volunteers were analyzed. According to the absolute neutrophil count (ANC), patients with hematological diseases without infection were divided into the normal ANC, ANC reduced, and ANC deficiency groups. There was no statistically significant difference in the nCD64 index between these three groups (P = 0.586). However, there was a difference in the nCD64 index among the non-infected (0.74 ± 0.26), locally infected (1.47 ± 1.10), and sepsis (2.62 ± 1.60) groups (P < 0.001). The area under the diagnosis curve of the nCD64 index, evaluated as the difference between the sepsis and locally infected group, 0.777, which was higher than for PCT (0.735) and hs-CRP (0.670). The positive and negative likelihood ratios were also better for the nCD64 index than either PCT and hs-CRP.
CONCLUSION Our results indicate the usefulness of the nCD64 index as an inflammatory marker of early sepsis in hematological patients.
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Affiliation(s)
- Yu-Xi Shang
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Zhi Zheng
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Min Wang
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Hui-Xia Guo
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Yi-Juan Chen
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Yue Wu
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Xing Li
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Qian Li
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Jian-Ying Cui
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Xiao-Xiao Ren
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
| | - Li-Ru Wang
- Department of Hematology, Fuxing Hospital, Eighth Clinical Medical College, Capital Medical University, Beijing 100038, China
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19
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He Z, Liu JJ, Shu GF, Ma SL, Wu GQ. Diagnostic Utility of CD64 and CD38 Biomarkers for the Differential Diagnosis of Infections. Genet Test Mol Biomarkers 2022; 26:133-139. [PMID: 35230865 DOI: 10.1089/gtmb.2021.0269] [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: 11/12/2022] Open
Abstract
Purpose: Identification of infection type in patients with fever is particularly important in the emergency departments (EDs) of hospitals. This study aimed to evaluate the performance of two biomarkers, namely the modified neutrophil CD64 (nCD64) index and CD38 present on T cells, using flow cytometry. Methods: A total of 305 potentially infected patients with fever were admitted to the ED of Zhongda Hospital (Nanjing, China) between March 2021 and August 2021. This study grouped 180, 30, and 65 patients as having bacterial (local, Gram-positive, and Gram-negative infections), viral, or no infections, respectively, based on their diagnostic outcomes and clinical records. Results: The expression level of traditional/modified nCD64 was significantly increased in the bacterial infection group, especially in case of patients infected with Gram-negative bacteria, and the main infectious strains were Staphylococcus and Escherichia coli. Similarly, CD3+CD38+ cell percentages were elevated in patients with viral infections, which were mostly caused by Epstein-Barr virus and cytomegalovirus. CD38 expression is age dependent, and high percentages of CD3+CD38+ cells were observed in children with viral infections. For the prediction of bacterial infections, the area under the curve (AUC) of modified nCD64 (AUC: 0.800) was significantly higher than that of C-reactive protein and heparin-binding protein but slightly lower than that of traditional nCD64 (AUC: 0.831). The AUC, specificity, and sensitivity values for the prediction of viral infections using CD3+CD38+ cells percentages in children were 0.899 (0.785-1.000), 96.2%, and 85.9%, respectively. Conclusion: nCD64 levels and CD3+CD38+ cell percentage are potential biomarkers that facilitate identification of patients with bacterial and viral infections.
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Affiliation(s)
- Zhi He
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Jing-Jing Liu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guo-Fang Shu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Shao-Lei Ma
- Department of Emergency and Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guo-Qiu Wu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
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Yao Y, Zhao J, Hu J, Song H, Wang S, Ying W. Identification of potential biomarkers and immune infiltration in pediatric sepsis via multiple-microarray analysis. EUR J INFLAMM 2022. [DOI: 10.1177/1721727x221144392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Immune adjustment has become a sepsis occurring in the development of an important mechanism that cannot be ignored. This article from the perspective of immune infiltration of pediatric sepsis screening markers, and promote the understanding of disease mechanisms. Bioinformatics integrated six data sets of pediatric sepsis by using the surrogate variable analysis package and then analyzed differentially expressed genes (DEGs), immune infiltration and weighted gene co-expression network analysis of characteristics (WGCNA) of immune infiltration between pediatric sepsis and the control. Common genes of WGCNA and DEGs were used to functional annotation, pathway enrichment analysis and protein-protein interaction network. Support vector machine (SVM), least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to confirm the key genes for the diagnosis of pediatric sepsis. Receiver operating characteristic (ROC) curve, C index, principal component analysis (PCA) and GiViTi calibration band were used to evaluate the diagnostic performance of key genes. Decision curve analysis (DCA) was used to evaluate the clinical application value of key genes. Lastly, the correlation between key genes and immune cells was analyze. NK cells Resting and NK cell activated in pediatric sepsis during immune infiltration were significantly lower than those in the control group, while M1 Macrophages were higher than those in the control group. ROC, C-index, PCA, GiViTi calibration band and DCA indicated that MCEMP1, CD177, MMP8 and OLFM4 had high diagnostic performance for pediatric sepsis. There is a negative correlation between 4 key genes and NK cells resting, NK cells activated. Except for MCEMP1, the other 3 genes were positively correlated with M1 Macrophages. This study revealed differences in immune responses in pediatric sepsis and identified four key genes as potential biomarkers. Pediatric sepsis in pathology maybe understood better by learning about how it develops.
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Affiliation(s)
- Yinhui Yao
- Department of Pharmacy, The Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Jingyi Zhao
- Department of Functional Center, Chengde Medical University, Chengde, China
| | - Junhui Hu
- Department of Pharmacy, The Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Hong Song
- Department of Pharmacy, The Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Sizhu Wang
- Office of Drug and Medical Device Clinical Trial Institution, The Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Wang Ying
- Department of Pharmacy, The Affiliated Hospital of Chengde Medical University, Chengde, China
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