Spontaneous luminol-dependent chemiluminescence of thrombocytes increases in hemorrhagic fever with renal syndrome

Chemiluminescent Analysis of Light-Irradiated Leukocytes as a Diagnostic Tool for Fast Identification of Pathological States

OBJECTIVE

Reactive oxygen species (ROS), mainly produced by polymorphonuclear neutrophils (PMN), are a significant part of host defense in pathologic states. We attempted to relate numbers of PMN and ROS generated within PMN to develop an alternative photochemical approach for evaluation of the potential of these cells to resist the development of inflammatory pathology.

BACKGROUND DATA

Lack of sensitivity to light has been reported in healthy cells, while sensitivity to light characterizes cell pathology.

METHODS

Human leukocytes from 34 donors were isolated and irradiated with a non-laser blue light (2 and 5 mW/cm(2) for 2 minutes), and a luminol-dependent chemiluminescence assay that reflects intracellular production of ROS was applied thereafter. The levels of basal chemiluminescence (BCL) were related to respective numbers of PMN.

RESULTS

A light-insensitive cluster was discovered within the total sample and was considered to be a discrete nonpathological group. Following elimination of this group, the rest of the sample was divided into three well-defined light-sensitive groups, which were attributed to various pathological states, and differed in PMN numbers and BCL counts. Within these groups the two traits were interrelated, and each PMN range was associated with a respective level of intracellular ROS.

CONCLUSIONS

Leukocyte responsiveness to light can be used for discrimination between pathological and nonpathological states and prognostic evaluation of pathological development. Patients exhibiting similar clinical symptoms could be divided into separate groups with potentially different outcomes. A novel definition of nonpathological states as well as the mechanism underlying the bell-shaped curve that delineates the relationship between PMN number and intracellular ROS is suggested in pathological states.

Pathogenetic and clinical aspects of the renal involvement in hemorrhagic fever with renal syndrome

Hemorrhagic fever with renal syndrome is the most common clinical manifestation of hantavirus infection. The main target organ is the kidney, resulting in an interstitial hemorrhagic nephritis and sometimes acute tubular necrosis. The pathogenesis is still largely unknown, but several recent studies indicate an important role for immune mechanisms including increased expression of cytokines, for example, tumor necrosis factor. Immunohistochemical studies of kidney biopsies have revealed deposits of IgG, IgM, and C3, but deposits were significantly less numerous than in chronic immune complex disease. Since hantaviruses are not cytolytic, a direct detrimental effect of the infecting virus is less likely. The long-term prognosis of hemorrhagic fever with renal syndrome seems to be favorable, but there are reports that previous hantavirus infection is associated with an increased risk of hypertensive renal disease. Prospective longitudinal studies addressing this issue are underway.