Combined leukocyte and erythrocyte aggregation in the peripheral venous blood during sepsis. An indication of commonly shared adhesive protein(s)

Abstract

We have used a simple slide test and image analysis to reveal the state of leukocyte and erythrocyte adhesiveness/aggregation in the peripheral blood of 28 patients with sepsis and 28 controls. A significant (P<0.00001) increment in both leukocyte and erythrocyte adhesiveness/aggregation was noted in patients compared with controls. Moreover, a significant (r=0.73, n=56, P<0.001) correlation was noted between the two adhesiveness/aggregation variables themselves, suggesting a common mechanism responsible for these adhesive phenomena. The significant correlation with fibrinogen suggests that this protein might be such a "non-specific glue." Our results indicate that a simple slide technique and image analysis can assess the aggregability of both white and red blood cells in septic patients. This might have clinical application when interventions to reduce cell aggregability are planned in order to improve blood flow in the microcirculation.

Rheological determinants in patients with Gaucher disease and internal inflammation

“…The first describes the area of the slide (in microns) covered by the red blood cells, while the VR is a measurement (in microns) of the space that is formed between the aggregation cells. Variabilities of this test are described elsewhere [16].…”

The Usefulness of an Inflammation Meter to Detect the Presence of Infection/Inflammation in Elderly Patients

“…It is based on the known observations that this response is accompanied by the appearance of increased leukocyte numbers in the peripheral circulating pool of blood, increased leukocyte adhesiveness/aggregation, as well as enhanced synthesis of adhesive proteins (fibrinogen, for example) that can induce leukocyte as well as erythrocyte aggregation (10). Because all of these phenomena can be detected at real time and low cost by using a simple slide test (1)(2)(3)(4)(5)(6)8), the next question is whether the diagnostic yield of our novel approach is comparable to what can be obtained by "conventional" markers, including the WBCC, erythrocyte sedimentation fibrinogen, or quantitative CRP concentrations. By using the same cohort of elderly patients, we could indeed show that the discrimination between the presence or absence of an inflammatory response in elderly patients with acute bacterial infections is as good as the one obtained by the above-mentioned conventional methods (6).…”

“…They were scanned by using an image analysis system (INFLAMET TM , Inflamet Ltd., Tel Aviv, Israel), the details of which were recently described (1)(2)(3)(4)(5)(6). This system enables us to count the number of peripheral blood leukocytes per mm 2 as well as determine their degree of adhesiveness/aggregation (percent of aggregated leukocytes) ( Figure 1).…”

“…We have recently introduced a new approach of scanning peripheral blood slides to detect the number of white blood cells as well as their degree of adhesiveness/aggregation in addition to the aggregability of erythrocytes (1)(2)(3)(4)(5). This technology will enable any paramedical personnel to obtain relevant information related to the acute phase response at any given time.…”

Erythrocyte–Platelet Interaction in Uncomplicated Pregnancy

“…Fibrinogen is crucial for hemostasis and has also been deemed an acute-phase protein involved in the process of inflammation, as it displays binding sites for distinctive cellular receptors expressed by cells involved in the inflammatory process (Kamath & Lip, 2003;Adams et al, 2007). As it acts as a "nonspecific glue," it can enhance the adhesion and aggregation of RBCs (Berliner et al, 2000). Low flow rate, which is the cause of deep vein thrombosis, has been shown to induce receptor-mediated RBC adhesion to platelets and/or fibrin (Goel & Diamond, 2002).…”