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Updated: May 23, 2025
Measuring Granulocyte and Monocyte Phagocytosis and Oxidative Burst Activity in Human Blood
Published on: September 12, 2016
Decreased neutrophil oxidative burst activity in children with failure to thrive - a pilot study
Saumya Jindal1, Richa Gupta1, Pooja Dewan2
1Department of Pathology, University College of Medical Sciences Dilshad Garden, Delhi 110095, India.
Insights
Children with failure to thrive (FTT) exhibit reduced neutrophil oxidative burst activity, impairing pathogen killing. This study highlights the need to investigate primary immunodeficiencies, like chronic granulomatous disease (CGD), in FTT cases.
Area of Science:
- Pediatrics
- Immunology
- Hematology
Background:
- Failure to thrive (FTT) in children can stem from malnutrition or underlying diseases, increasing infection risk.
- Altered immune responses, particularly neutrophil function, are implicated but understudied in FTT.
- Primary immunodeficiencies (PIDs) are rare causes of FTT, necessitating further investigation.
Purpose of the Study:
- To evaluate neutrophil functional activity in children with FTT.
- To utilize a sensitive flow cytometry assay for assessing neutrophil oxidative burst.
Main Methods:
- Assessed 25 children with FTT and 25 healthy controls.
- Measured hematological parameters and neutrophil oxidative burst using DHR assay via flow cytometry.
Main Results:
- FTT cases showed lower hemoglobin, hematocrit, RBC, and MCHC, with higher eosinophils (P<0.0001).
- Neutrophil Oxidative Index (NOI) was significantly reduced in FTT children (P<0.0001).
- One FTT case (4%) presented with absent neutrophil response, later confirmed as chronic granulomatous disease (CGD) with a CYBB mutation.
Conclusions:
- Children with FTT demonstrate a diminished neutrophil oxidative burst, indicating impaired phagocyte pathogen-killing capacity.
- Screening for CGD is crucial in children diagnosed with FTT.
Introduction:
Failure to thrive (FTT) refers to failure of expected weight gain, striking lack of well-being and inadequate physical growth in children. The causes vary with geographical and socio-economic factors. In developed countries, FTT is usually a symptom of an underlying disease, often a gastrointestinal or neurological disorder. However, in developing countries, FTT is often associated with inadequate caloric intake and malnutrition. Such children are at an increased risk of infections and infection-related mortality which may be related to altered immune responses. Rarely some Primary immunodeficiencies (PIDs) can manifest as FTT. Not much data regarding neutrophil functions in these children is available.
Objectives:
The present study aimed to analyse the functional activity of neutrophils in children with FTT using a highly sensitive and specific flow cytometry-based assay.
Methods:
25 children with FTT (up to 5 years) and 25 healthy controls were assessed for haematological parameters and neutrophil oxidative burst activity by DHR Assay using Flow cytometry.
Results:
Compared to controls, the cases had significantly lower haemoglobin, hematocrit, RBC count and MCHC but a higher eosinophil count (P<0.0001). On flow cytometry, the Neutrophil Oxidative Index (NOI) was significantly reduced in cases (P<0.0001). 1 of 25 cases (4%) showed no change in neutrophil fluorescence after stimulation, suggesting the presence of CGD, which was later confirmed with molecular assay revealing a CYBB mutation.
Conclusions:
To conclude, children with FTT have a decreased Neutrophil Oxidative Burst, suggesting defective killing of pathogens by phagocytes. Also, the presence of CGD should be ruled out in such children.
