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Quantitative Assessment of Immune Cells in the Injured Spinal Cord Tissue by Flow Cytometry: a Novel Use for a Cell Purification Method
Published on: April 9, 2011
A Pilot Study Assessing the Utility of Quantitative Myeloid-Derived Suppressor Cell Measurements in Detecting
Grant E O'Keefe1, Yiyang Wu2, Nina Mirabadi1
1Department of Surgery, University of Washington, School of Medicine, Seattle, WA.
Objectives:
Biomarkers that facilitate earlier diagnosis of posttraumatic infection could improve outcomes by expediting treatment and mitigating complications, including sepsis. We hypothesized that circulating myeloid-derived suppressor cell (MDSC) counts could identify patients with posttraumatic infection.
Design Setting And Patients:
We conducted a single-center, prospective observational pilot study of trauma victims who required greater than or equal to 48 hours of mechanical ventilation. Whole blood was collected and tested by flow cytometry.
Interventions:
None.
Measurements And Main Results:
Samples were analyzed in real-time with an 11-parameter quantitative MDSC assay. Two physician adjudications of infection were performed through a blinded review of medical records. MDSC and other cell counts were compared between subjects with and without posttraumatic infection using non-parametric methods. Data are presented as medians (25th-75th percentile). The area under the receiver operating characteristic (ROC) curves were used to assess the accuracy of cell counts for diagnosing infection. Most subjects (n = 39) were male (79%) with a median age of 48 (interquartile range [IQR] 32-65), Injury Severity Score of 29 (IQR 21-41), and ICU length of stay of 13 days (IQR 8-19). Twenty-one (54%) developed an infection and 11 (28%) of the cohort died. We compared total MDSC (T-MDSC) counts closest to the day of infection diagnosis with the initial T-MDSC counts in subjects without infection. T-MDSC counts were higher in those with infection compared to those without infection (696 [368-974] and 304 [181-404] cells/μL, respectively; p < 0.001). Lymphocyte, neutrophil, and CD45+ leukocyte counts were not statistically different between the groups. The area under the ROC curve distinguishing those with infection from those without for T-MDSC was 0.83 (p < 0.001).
Conclusions:
MDSC counts determined by quantitative whole blood flow cytometrics can detect posttraumatic infection and may be useful to guide further diagnostic testing in critically ill trauma victims.
Insights
Myeloid-derived suppressor cell (MDSC) counts can help identify posttraumatic infections in critically ill patients. Higher MDSC levels indicate infection, aiding early diagnosis and treatment.
Area of Science:
- Critical care medicine
- Immunology
- Trauma surgery
Background:
- Early diagnosis of posttraumatic infection is crucial for improving patient outcomes.
- Sepsis and other complications can arise from delayed infection detection.
- Biomarkers are needed to facilitate timely diagnosis in trauma patients.
Purpose of the Study:
- To investigate if circulating myeloid-derived suppressor cell (MDSC) counts can identify posttraumatic infections.
- To evaluate MDSC counts as a potential biomarker for early infection detection in trauma victims.
Main Methods:
- A prospective observational pilot study was conducted on trauma patients requiring prolonged mechanical ventilation.
- Whole blood samples were analyzed using flow cytometry to quantify MDSC and other cell counts.
- Infection status was determined by physician adjudication, and cell counts were compared between infected and non-infected groups.
Main Results:
- Patients with posttraumatic infection had significantly higher total MDSC (T-MDSC) counts compared to those without infection (696 vs. 304 cells/μL; p < 0.001).
- The area under the receiver operating characteristic (ROC) curve for T-MDSC in diagnosing infection was 0.83 (p < 0.001).
- Lymphocyte, neutrophil, and CD45+ leukocyte counts did not differ significantly between groups.
Conclusions:
- Quantitative whole blood flow cytometry for MDSC counts can detect posttraumatic infections.
- MDSC counts show promise as a biomarker to guide further diagnostic testing in critically ill trauma patients.
