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Neutrophil CD64 expression is associated with severity and prognosis of disseminated intravascular coagulation
Sang Hoon Song1, Hyun Kyung Kim, Myoung Hee Park
1Department of Laboratory Medicine, Seoul National University, College of Medicine, Seoul, Korea.
Insights
Neutrophil CD64 expression, a marker for neutrophil activation, correlates with disseminated intravascular coagulation (DIC) severity. This marker shows strong predictive value for 28-day mortality in DIC patients, aiding disease monitoring.
Area of Science:
- Hematology
- Immunology
- Critical Care Medicine
Background:
- Disseminated intravascular coagulation (DIC) involves microcirculatory disturbances activating neutrophils.
- The relationship between neutrophil activation and DIC severity/prognosis remains unclear.
Purpose of the Study:
- To investigate the link between neutrophil activation and DIC severity.
- To assess the prognostic value of neutrophil activation markers in DIC patients.
Main Methods:
- Measured neutrophil CD64 expression and plasma neutrophil elastase in 94 suspected DIC patients and 55 controls.
- Utilized CD64 quantitation and PMN Elastase enzyme immunoassay kits.
Main Results:
- Neutrophil CD64 and elastase were elevated in DIC patients versus controls (P<0.001).
- CD64 expression correlated linearly with DIC score (P<0.001).
- Higher CD64 levels were seen in non-survivors (P<0.001 for overt, P=0.032 for non-overt DIC).
Conclusions:
- Neutrophil CD64 expression correlates with DIC severity.
- CD64 expression is a valuable predictor of 28-day mortality in DIC.
- CD64 may aid in monitoring DIC progression and patient outcomes.
Introduction:
Although neutrophil can be activated by microcirculatory disturbances in DIC, its relation with the severity and prognosis of DIC has not been elucidated. We investigated the relationship between neutrophil activation and DIC severity and determined the prognostic value of neutrophil activation markers in patients with DIC.
Materials And Methods:
We measured two neutrophil activation markers, neutrophil CD64 expression and plasma neutrophil elastase, in 94 patients with suspected DIC and 55 healthy controls. Neutrophil CD64 expression and plasma neutrophil elastase were measured using CD64 quantitation kit, and PMN Elastase enzyme immunoassay kit.
Results:
Neutrophil CD64 expression and plasma neutrophil elastase level were significantly increased in patients with overt and non-overt DIC compared to normal controls (P<0.001, each). Neutrophil CD64 expression showed a significant linear trend of increase with increasing DIC score (P<0.001). In DIC patients, significant differences were observed between those with and without infection both in overt (P=0.003) and non-overt DIC (P=0.004). Neutrophil CD64 expression was significantly increased in 28-day non-survival group compared to survival group in both overt (P<0.001) and non-overt DIC (P=0.032). The 28-day survival rate showed a stronger association with the neutrophil CD64 expression (P<0.001) than with DIC score (P=0.028) or plasma neutrophil elastase level (P=0.246).
Conclusions:
Neutrophil CD64 expression is significantly correlated with DIC severity and has a good predictive value for the 28-day mortality in patients suspected of having DIC. Neutrophil CD64 expression might be useful in monitoring the disease course and in predicting mortality in DIC patients.