Neutrophil and monocyte receptor expression in patients with sepsis: implications for diagnosis and prognosis of sepsis

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.

Assessment of continuous neutrophil CD64 index measurement for diagnosing sepsis and predicting outcome in a Chinese pediatric intensive care unit: a prospective study

“…We also evaluated the performance of the continuous nCD64 index in predicting death, and a significant association between the baseline nCD64 index and inhospital death was observed (OR: 2.18, 95% CI: 1.02-4.74), which is consistent with previous studies in neonates (12,20). In this study, a positive significant association between nCD64 index decline and death was observed (OR: 1.31, 95% CI: 1.07-1.58) in the crude model.…”

Immunomonitoring of Monocyte and Neutrophil Function in Critically Ill Patients: From Sepsis and/or Trauma to COVID-19

“…In a recent study with a small sample size, authors did not find alterations of monocytes in patients with sepsis. in addition, they reported that monocyte CD64 expression was not related to mortality risk in this patient population [243]. This is in accordance with our results (unpublished data) from our investigation of 86 critically ill patients with secondary sepsis.…”

“…The group consequently concluded that early flow cytometric measurements of CD64 +ve granulocytes could help clinicians to target patients at high risk of clinical deterioration [242]. In one study, expression of CD64 on neutrophils was specific for discriminating patients with sepsis but showed weak sensitivity [243].…”

Bulk RNA Sequencing With Integrated Single-Cell RNA Sequencing Identifies BCL2A1 as a Potential Diagnostic and Prognostic Biomarker for Sepsis

“…In addition, it also demonstrated that CD64 was significantly elevated in monocyte/macrophage cells, which was consistent with previously published studies ( 29 , 30 ). However, controversy remains about whether CD64 expression on monocytes can be a diagnostic and prognostic biomarker for sepsis ( 31 ). Some researchers found that simultaneously analyzing CD64 expression for both types of cells can improve the accuracy of diagnosis ( 32 ).…”