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Parameters influencing membrane CD14 expression and soluble CD14 levels in sepsis
1Division of Molecular Medicine, North Shore University Hospital, Manhasset, NY, USA. thomas.glueck@klinik.uni-regensburg.de
Introduction:
Membrane (mCD14) and soluble (sCD14) CD14 are pattern recognition receptors for bacterial cell wall fragments. They play an important role in the generation of the innate immune response against bacterial pathogens. Differential expression of these receptors may be relevant for the clinical course of patients with sepsis.
Patients And Methods:
32 patients with an early onset of sepsis (duration of symptoms < 24h) were examined repeatedly by flow cytometry for expression of mCD14, and by ELISA for levels of sCD14, leukocyte elastase and C-reactive Protein (CRP).
Results:
At study entry, mCD14 expression was reduced in all patients with sepsis, but returned to normal levels during the course of the disease in survivors only. mCD14 was found to be inversely correlated with severity of disease, leukocyte elastase, and C-reactive protein. Among patients with severe disease and Apache II scores >or= 20, sCD14 levels at study entry were significantly higher in those who survived by day 28, as compared to non-survivors (p = 0.02).
Conclusion:
The data presented are compatible with a recently published hypothesis derived from in vitro experiments suggesting that leukocyte elastase may be responsible for cleavage of mCD14 from the monocyte surface. The data also suggest that higher sCD14 levels may be beneficial in sepsis. Persistently reduced mCD14 expression seems to be a marker for severity of disease in patients with sepsis.
Insights
Reduced membrane CD14 (mCD14) expression in sepsis patients indicates disease severity. Higher soluble CD14 (sCD14) levels may aid survival, suggesting differential CD14 roles in sepsis outcomes.
Area of Science:
- Immunology
- Infectious Diseases
- Critical Care Medicine
Background:
- CD14, a pattern recognition receptor, is crucial for innate immunity against bacterial pathogens.
- Both membrane (mCD14) and soluble (sCD14) forms of CD14 are involved in immune responses.
- Differential expression of CD14 may influence sepsis patient outcomes.
Purpose of the Study:
- To investigate the role of mCD14 and sCD14 in early-onset sepsis.
- To correlate CD14 levels with disease severity and patient outcomes.
Main Methods:
- Flow cytometry was used to measure mCD14 expression.
- ELISA quantified sCD14, leukocyte elastase, and C-reactive protein (CRP) in 32 sepsis patients.
- Repeated measurements were taken throughout the study.
Main Results:
- Sepsis patients initially showed reduced mCD14 expression, which normalized in survivors.
- mCD14 levels inversely correlated with disease severity, leukocyte elastase, and CRP.
- Higher sCD14 levels at study entry were associated with 28-day survival in severe sepsis patients.
Conclusions:
- Persistently low mCD14 expression is a marker of sepsis severity.
- Leukocyte elastase may cleave mCD14 from monocyte surfaces.
- Elevated sCD14 levels might be protective in sepsis.
