Neutrophil Dysfunction, Immature Granulocytes, and Cell-free DNA are Early Biomarkers of Sepsis in Burn-injured Patients: A Prospective Observational Cohort Study.

نویسندگان

  • Peter Hampson
  • Robert J Dinsdale
  • Christopher M Wearn
  • Amy L Bamford
  • Jonathan R B Bishop
  • Jon Hazeldine
  • Naiem S Moiemen
  • Paul Harrison
  • Janet M Lord
چکیده

OBJECTIVE The aim of this study was to measure neutrophil function longitudinally following burn injury and to examine the relationship between neutrophil dysfunction and sepsis. BACKGROUND Sepsis prevalence and its associated mortality is high following burn injury, and sepsis diagnosis is complicated by the ongoing inflammatory response. Previous studies have suggested that neutrophil dysfunction may underlie high infection rates and sepsis postburn; however, neutrophil dysfunction has not been thoroughly characterized over time in burns patients. METHODS Neutrophil phagocytosis, oxidative burst capacity, and neutrophil extracellular trap (NET) generation (NETosis) were measured from 1 day to up to 1 year postburn injury in 63 patients with major burns (≥15% total body surface area). In addition, immature granulocyte (IG) count, plasma cell-free DNA (cfDNA), and plasma citrullinated histone H3 (Cit H3) levels were measured. RESULTS Neutrophil function was reduced for 28 days postburn injury and to a greater degree in patients who developed sepsis, which was also characterized by elevated IG counts. Plasma cfDNA and Cit-H3, a specific marker of NETosis, were elevated during septic episodes. The combination of neutrophil phagocytic capacity, plasma cfDNA levels, and IG count at day 1 postinjury gave good discriminatory power for the identification of septic patients. CONCLUSION Neutrophil function, IG count, and plasma cfDNA levels show potential as biomarkers for the prediction/early diagnosis of sepsis postburn injury and neutrophil dysfunction may actively contribute to the development of sepsis. Targeting neutrophil dysfunction and IG release may be a viable therapeutic intervention to help reduce the incidence of nosocomial infections and sepsis postburn.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Neutrophil dysfunction, immature granulocytes and cell-free DNA are early biomarkers of sepsis in burn injured patients

• Users may freely distribute the URL that is used to identify this publication. • Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. • User may use extracts from the document in line with the concept of ‘fair dealing’ under the Copyright, Designs and Patents Act 1988 (?) • Us...

متن کامل

Volume, Conductivity and Scatter parameters of Neutrophils in Neonatal Sepsis – Is it a Cost-Effective Tool?

Background: Early diagnosis of neonatal sepsis is quite challenging. I/T ratio (immature to mature neutrophil ratio) is a highly sensitive marker of sepsis but is time-consuming and subjective. Off late, volume conductivity and scatter (VCS) of neutrophils are among the newer parameters available for screening a septic neonate. This study aimed to determine the correlation between the I/T ratio...

متن کامل

Eosinopenia and Neutrophil to lymphocyte ratio as diagnostic tools in neonatal early onset sepsis -a single center observational study

Background and Objective: Neonatal sepsis is associated with high mortality and has a favourable outcome when recognized and treated in a timely manner. In resource-limited settings, there is a need for an affordable test with a short turnaround time for timely diagnosis of sepsis. The aim of this study was to find out the role of eosinopenia and neutrophil-to-lymphocyte ratio (NLR) in screenin...

متن کامل

Early Detection of Renal Dysfunction in β Thalassemia with Focus on Novel Biomarkers

Improved survival among transfusion dependent thalassemia patients in recent years has led to the manifestation of morbidities such as renal dysfunction. Renal injury is still an underestimated complication in β thalassemia major patients. Chronic anemia, iron overload due to repeated transfusion, and specific iron chelators are the main factors in pathogenesis of renal dysfunction in β thalass...

متن کامل

Outcome of Patients with Cholinergic Insecticide Poisoning Treated with Gastric Lavage: A Prospective Observational Cohort Study

Background: Gastric lavage (GL) is one of the most commonly used decontamination method for cholinergic insecticide ingestion in developing countries despite lack of supporting evidence. This study was designed to evaluate the outcome of patients with cholinergic insecticide poisoning treated with GL in regards to timing and frequency of the procedure. Methods: In this prospective observational...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Annals of surgery

دوره 265 6  شماره 

صفحات  -

تاریخ انتشار 2017