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Published on: February 7, 2025
Peripheral blood monocyte status is a predictor for judging occurrence and development on sepsis in older adult
Qian Gao1, Li Yang1, Fei Teng2
1Emergency Department, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, China.
Background:
Peripheral blood monocytes are important immune modulatory cells that change during aging. Previous studies on sepsis and monocytes did not distinguish between age groups, especially in the older adult population. The mechanisms of monocyte subsets and function are not well-understood in the aging context with sepsis.
Methods:
Monocyte subsets were measured using flow cytometry in 80 sepsis patients and 40 healthy controls. Plasma cytokine levels were measured using cytokine antibody arrays.
Results:
The percentage of MO3 (CD14 + CD16 + +)/monocytes was higher in sepsis patients than in controls (P = 0.011), whereas the percentage of MO1 (CD14 + + CD16 -)/monocytes was higher in septic shock patients and 28-day death group than in those without shock and 28-day survival group (P = 0.034, 0.038). Logistic regression analysis showed that the percentage of MO3/monocytes (OR = 1.120, P = 0.046) and plasma level of monocyte chemoattractant protein (MCP)-1 (OR = 1.006, P = 0.023) were independently associated with the occurrence of sepsis, whereas the percentage of MO1/monocytes (OR = 1.255, P = 0.048) was independently associated with septic shock. The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of MO3/monocyte percentage in combination with MCP-1 plasma level (AUC = 0.799) for predicting sepsis was higher than that of each parameter alone (P < 0.001). The AUC of MO1/monocyte percentage with the value 0.706 (P = 0.003) was lower than the AUC of SOFA (sequential organ failure assessment) score with the value 0.966 (P < 0.001) for predicting septic shock, but the value of the two AUCs were similar for predicting 28-day mortality (AUC = 0.705, 0.827; P = 0.020, P < 0.001). The AUC of MO1/monocytes percentage in combination with SOFA score for predicting 28-day mortality was higher than that of each parameter alone (AUC = 0.867, P < 0.001). Using a cut-off of 58.5% (for MO1/monocytes determined by ROC) could discriminate between survivors and non-survivors on Kaplan-Meier curves for 28-day mortality with a positive predictive value of 77.4%.
Conclusion:
The MO3/monocyte percentage and plasma MCP-1 level were independent predictors of sepsis occurrence, whereas the percentage of MO1/monocytes was an independent predictor of prognosis in the Chinese Han older adult population.
Trial Registration:
Registration number: ChiCTR2200061490, date of registration: 2022-6-26 (retrospectively registered).
Insights
Monocyte subset MO3 and MCP-1 predict sepsis occurrence, while MO1 predicts prognosis in older adults. These findings aid in understanding sepsis in aging populations.
Area of Science:
- Immunology
- Gerontology
- Critical Care Medicine
Background:
- Aging alters peripheral blood monocyte function, impacting immune responses.
- Previous sepsis research often overlooks age-specific monocyte dynamics, particularly in older adults.
- Mechanisms of monocyte subsets in aging individuals with sepsis remain poorly understood.
Purpose of the Study:
- To investigate the role of monocyte subsets in sepsis among older adults.
- To identify monocyte-derived biomarkers for sepsis prediction and prognosis.
- To explore the association between monocyte subsets, cytokines, and clinical outcomes in sepsis.
Main Methods:
- Flow cytometry was used to analyze monocyte subsets (MO1, MO3) in 80 sepsis patients and 40 controls.
- Plasma cytokine levels, including monocyte chemoattractant protein (MCP)-1, were measured.
- Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were performed to assess predictive values.
Main Results:
- MO3 monocyte percentage was higher in sepsis patients; MO1 monocyte percentage was higher in septic shock and non-survivor groups.
- MO3 monocyte percentage and plasma MCP-1 independently predicted sepsis occurrence.
- MO1 monocyte percentage independently predicted septic shock and 28-day mortality, showing potential as a prognostic marker.
Conclusions:
- Monocyte subsets MO3 and MO1, along with MCP-1, serve as valuable indicators in sepsis.
- MO3/monocyte percentage and plasma MCP-1 are independent predictors of sepsis occurrence.
- MO1/monocyte percentage is an independent predictor of prognosis in older adults with sepsis.
