Monocyte Dysfunction Detected by the Designed Ankyrin Repeat Protein F7 Predicts Mortality in Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is used for critically ill patients requiring hemodynamic support but has been shown to induce an inflammatory response syndrome potentially leading severe complications and poor outcome. Monocytes are comprised of different subsets play a central role in the innate immune system. The unique small binding proteins, Designed Ankyrin Repeat Protein “F7” single chain variable fragment “MAN-1,” specifically detect activated conformation leukocyte integrin Mac-1 enabling highly sensitive detection monocyte activation status. aim this study was characterize function heterogeneity their association with outcome VA-ECMO patients. Methods: were recruited from ICUs University Hospital Freiburg, Germany. Blood sampled on day 0 3 after placement, explantation healthy controls. Monocyte subset distribution, baseline stimulability analyzed by flow cytometry using proteins F7 MAN-1 conventional markers CD163, CD86, CD69, CX3CR1. Furthermore, expression survivors non-survivors compared. Simple logistic regression conducted determine mortality. Results: Twenty two 15 controls recruited. Eleven survived until discharge ICU. Compared controls, significantly increased, whereas decreased. percentage classical monocytes increased explantation, while intermediate Total, classical, counts elevated compared On 0, lower than survivors. area under ROC curve associated mortality 0.802 ( p = 0.02). Conclusions: Distribution changes during absolute showed signs dysfunction. dysfunction, as determined tool F7, could be valuable predicting receiving may novel biomarker guiding early clinical decision making future.