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Jukema BN, de Hond TAP, Kroon M, Maranus AE, Koenderman L, Kaasjager KAH. Point-of-care neutrophil and monocyte surface markers differentiate bacterial from viral infections at the emergency department within 30 min. J Leukoc Biol 2024; 115:714-722. [PMID: 38169315 DOI: 10.1093/jleuko/qiad163] [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: 10/11/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
Rapid discrimination between viral and bacterial infections in a point-of-care setting will improve clinical outcome. Expression of CD64 on neutrophils (neuCD64) increases during bacterial infections, whereas expression of CD169 on classical monocytes (cmCD169) increases during viral infections. The diagnostic value of automated point-of-care neuCD64 and cmCD169 analysis was assessed for detecting bacterial and viral infections at the emergency department. Additionally, their value as input for machine learning models was studied. A prospective observational cohort study in patients suspected of infection was performed at an emergency department. A fully automated point-of-care flow cytometer measured neuCD64, cmCD169, and additional leukocyte surface markers. Flow cytometry data were gated using the FlowSOM algorithm. Bacterial and viral infections were assessed in standardized clinical care. The sole and combined diagnostic value of the markers was investigated. Clustering based on unsupervised machine learning identified unique patient clusters. Eighty-six patients were included. Thirty-five had a bacterial infection, 30 had a viral infection, and 21 had no infection. neuCD64 was increased in bacterial infections (P < 0.001), with an area under the receiver operating characteristic curve (AUROC) of 0.73. cmCD169 was higher in virally infected patients (P < 0.001; AUROC 0.79). Multivariate analyses incorporating additional markers increased the AUROC for bacterial and viral infections to 0.86 and 0.93, respectively. The additional clustering identified 4 distinctive patient clusters based on infection type and outcome. Automated neuCD64 and cmCD169 determination can discriminate between bacterial and viral infections. These markers can be determined within 30 min, allowing fast infection diagnostics in the acute clinical setting.
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Affiliation(s)
- Bernard N Jukema
- Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
- Centre for Translational Immunology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Titus A P de Hond
- Department of Internal Medicine and Acute Medicine, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Martijn Kroon
- Centre for Translational Immunology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Anna E Maranus
- Centre for Translational Immunology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Leo Koenderman
- Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
- Centre for Translational Immunology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Karin A H Kaasjager
- Department of Internal Medicine and Acute Medicine, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
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Ogbodo E, Michelangeli F, Williams JHH. Exogenous heat shock proteins HSPA1A and HSPB1 regulate TNF-α, IL-1β and IL-10 secretion from monocytic cells. FEBS Open Bio 2023; 13:1922-1940. [PMID: 37583307 PMCID: PMC10549225 DOI: 10.1002/2211-5463.13695] [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: 04/17/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 08/17/2023] Open
Abstract
Endogenous molecules, such as heat shock proteins (HSP), can function as danger signals when released into the extracellular environment in response to cell stress, where they elicit an immune response such as cytokine secretion. There has also been some suggestion that contamination of exogenous HSPs with lipopolysaccharide (LPS) may be responsible for these effects. This study investigates the effects of exogenous HSPA1A and HSPB1 on the activation of immune cells and the resulting secretion of cytokines, which are involved in inflammatory responses. To address whether exogenous HSPs can directly activate cytokine secretion, naïve U937 cells, differentiated U937 cells and peripheral blood mononuclear cells (PBMCs) were treated with either exogenously applied HSPA1A or HSPB1 and then secreted IL-1β, TNF-α and IL-10 were measured by ELISA. Both HSPs were able to induce a dose-dependent increase in IL-10 secretion from naïve U937 cells and dose-dependent IL-1β, TNF-α and IL-10 secretion were also observed in differentiated U937 cells and PBMCs. We also observed that CD14 affects the secretion levels of IL-1β, TNF-α and IL-10 from cells in response to exogenous HSP treatment. In addition, HSPA1A and HSPB1 were shown to interact with CD14, CD36 and CD11b extracellular receptor proteins. Several approaches used in this study indicate that HSP-induced cytokine secretion is largely independent of any contaminating LPS in the samples.
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Lee HP, Liu SC, Wang YH, Chen BC, Chen HT, Li TM, Huang WC, Hsu CJ, Wu YC, Tang CH. Cordycerebroside A suppresses VCAM-dependent monocyte adhesion in osteoarthritis synovial fibroblasts by inhibiting MEK/ERK/AP-1 signaling. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104712] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Cybularz M, Wydra S, Berndt K, Poitz DM, Barthel P, Alkouri A, Heidrich FM, Ibrahim K, Jellinghaus S, Speiser U, Linke A, Christoph M, Pfluecke C. Frailty is associated with chronic inflammation and pro-inflammatory monocyte subpopulations. Exp Gerontol 2021; 149:111317. [PMID: 33744391 DOI: 10.1016/j.exger.2021.111317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 01/19/2023]
Abstract
AIM OF THE STUDY Frail patients with high grade aortic valve stenosis (AS) undergoing Transcatheter Aortic Valve Implantation (TAVI) have an increased mortality. A connection between frailty and inflammation has been suggested. Monocyte subpopulations are associated with both cardiovascular diseases and chronic inflammatory diseases. This study investigates the association of frailty with monocyte subpopulations and systemic inflammatory parameters in elderly patients undergoing TAVI. METHODS A total of 120 patients with symptomatic AS was examined. Before TAVI implantation, frailty was assessed by a bedside evaluation (eyeball test). In all patients a flow cytometry analysis has been performed. Monocyte subpopulations were defined as follows: classical (CD14++CD16-), intermediate (CD14++CD16+) and non-classical (CD14+CD16++). Expression of CD11b was measured as a marker for monocyte activation. Pro-inflammatory cytokines such as interleukin IL-8, as well as CRP were measured with Cytometric Bead Array or standard laboratory methods. RESULTS 28 out of 120 patients were frail. These patients showed both, signs of elevated chronic systemic inflammation reflected by elevated CRP (3.7 (1.4-5.4) vs. 5.9 (3.7-29.1), p = 0.001) and an elevated level of intermediate monocytes (37 (24-54) vs. 53 (47-63), p = 0.001). At 6 months after TAVI, 19 of 120 patients died, primarily without relevant dysfunction of the implanted aortic valve. Mortality was significantly higher in the frail as compared with non-frail patients (9 of 28 frail patients vs. 10 of 92 non frail patients, p < 0.001). A binary logistic regression analysis validated frailty and intermediate monocytes as independent predictors for early mortality after TAVI. CONCLUSION Chronic systemic inflammation and increased levels of intermediate monocytes are associated with frailty in old patients with severe aortic valve stenosis. Both the syndrome of frailty and elevated intermediate monocytes showed an association with early mortality after TAVI.
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Affiliation(s)
- Maria Cybularz
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Sandy Wydra
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Katharina Berndt
- Department of Cardiology, Universitätsklinikum Leipzig, Leipzig, Germany
| | - David M Poitz
- Institute for Clinical Chemistry and Laboratory Medicine, Technical University Dresden, Dresden, Germany
| | - Peggy Barthel
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Ahmad Alkouri
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Felix M Heidrich
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Karim Ibrahim
- Department of Cardiology, Technische Universität Dresden, Klinikum Chemnitz, Germany
| | - Stefanie Jellinghaus
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Uwe Speiser
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Axel Linke
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Marian Christoph
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany
| | - Christian Pfluecke
- Internal medicine, cardiology and intensive care medicine, Heart Center Dresden, Technical University Dresden, Dresden, Germany.
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Pfluecke C, Wydra S, Berndt K, Tarnowski D, Cybularz M, Jellinghaus S, Mierke J, Ende G, Poitz D, Barthel P, Heidrich F, Quick S, Sveric K, Speiser U, Linke A, Ibrahim K. Mon2-monocytes and increased CD-11b expression before transcatheter aortic valve implantation are associated with earlier death. Int J Cardiol 2020; 318:115-120. [DOI: 10.1016/j.ijcard.2020.05.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 12/25/2022]
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