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Published on: February 7, 2025
Monocyte CD14 and soluble CD14 in predicting mortality of patients with severe community acquired infection
Hannele Aalto1, Annika Takala, Hannu Kautiainen
1Department of Bacteriology and Immunology, The Haartman Institute, University of Helsinki, Finland. hannele.aalto@helsinki.fi
Abstract:
Monocyte membrane CD14 (mCD14) and soluble CD14 (sCD14) both associate with poor outcome in sepsis. Because the value of combined use of the markers is unknown we measured both in patients with severe community acquired infections. The study comprised 142 acutely ill patients with community acquired pneumonia and/or blood culture-positive sepsis. Expression of mCD14 was measured, on admission to hospital, by whole blood flow cytometry and sCD14 by ELISA. There was no significant correlation between mCD14 and sCD14. Patients in the lowest tertile of mCD14 were 9.79 times (95% CI 1.31- >50, p =0.006) more likely to die than patients in the middle/highest tertiles. Survival rates in the highest and middle/lowest tertiles of sCD14 levels were comparable. After stratification by sCD14, patients in the lowest tertile of mCD14 were 14.4 times (95% CI 1.90-39.44) more likely to die than patients in the middle/highest tertiles. A significant positive correlation was detected between C-reactive protein and sCD14 levels, providing evidence that sCD14 may serve as an acute phase reactant. In conclusion, low monocyte mCD14 level, unlike the concurrent sCD14 level, predicts 28-d mortality in patients with community acquired infections.
Insights
Low monocyte CD14 (mCD14) levels, but not soluble CD14 (sCD14), significantly predict mortality in severe infections. This finding highlights mCD14 as a crucial prognostic marker for sepsis outcomes.
Area of Science:
- Immunology
- Critical Care Medicine
- Biomarker Discovery
Background:
- Monocyte membrane CD14 (mCD14) and soluble CD14 (sCD14) are linked to adverse outcomes in sepsis.
- The combined prognostic value of mCD14 and sCD14 in severe infections remains unclear.
Purpose of the Study:
- To investigate the independent and combined predictive values of mCD14 and sCD14 for mortality in patients with severe community-acquired infections.
Main Methods:
- Whole blood flow cytometry was used to measure mCD14 expression on admission.
- Enzyme-linked immunosorbent assay (ELISA) determined sCD14 levels.
- Statistical analysis assessed correlations and mortality prediction.
Main Results:
- No significant correlation was observed between mCD14 and sCD14 levels.
- Low mCD14 tertile was strongly associated with increased 28-day mortality (OR 9.79).
- Low mCD14 remained a significant predictor of mortality even after stratification by sCD14 levels (OR 14.4).
- sCD14 levels showed a positive correlation with C-reactive protein, suggesting its role as an acute phase reactant.
Conclusions:
- Low monocyte CD14 expression is a significant predictor of 28-day mortality in severe community-acquired infections.
- Soluble CD14 levels do not appear to be an independent predictor of mortality in this context.
- mCD14 may serve as a valuable prognostic biomarker for critically ill patients with infections.
