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The adherence of polymorphonuclear leukocytes in patients with sepsis
Abstract:
Adherence of polymorphonuclear leukocytes (PMNLs) to nylon in patients with bacteremia was studied using a whole-blood assay. Adherence of PMNLs was studied in blood obtained from patients who were not in shock; the results did not differ from the control values (70.9% +/- 4.9% vs 72.1% +/- 2.8%, respectively; P greater than 0.3). Adherence of PMNLs in the whole blood of patients was studied 24-36 hr after antibiotic therapy was begun for documented bacteremia, and elevated values were demonstrated (79.2% +/- 8.6%; P less than 0.01). patients with bacteremic shock had a greatly augmented level of PMNL adherence (91.1% +/- 8.5%; P less than 0.001), and enhanced adherence was demonstrated when the normal PMNLs were suspended in plasma from hypotensive patients. The administration of methylprednisolone significantly reduced the adherence of PMNLs in the whole blood of four patients with bacteremia. Assay of PMNL adherence to nylon is a simple test with the potential of identifying bacteremic patients who are at risk of developing shock.
Insights
Polymorphonuclear leukocyte (PMNL) adherence to nylon is elevated in bacteremia patients, particularly those in shock. This simple assay may predict shock risk in bacteremic individuals.
Area of Science:
- Immunology
- Hematology
- Critical Care Medicine
Background:
- Polymorphonuclear leukocytes (PMNLs) play a crucial role in the immune response to bacterial infections.
- Assessing PMNL function, such as adherence, can provide insights into disease severity and patient outcomes.
- Bacteremia, a serious condition, can lead to life-threatening complications like shock.
Purpose of the Study:
- To investigate the adherence of PMNLs to nylon in patients with bacteremia.
- To determine if PMNL adherence levels correlate with the development of bacteremic shock.
- To evaluate the potential of a PMNL adherence assay as a predictive tool for shock risk.
Main Methods:
- A whole-blood assay was employed to measure PMNL adherence to nylon.
- PMNL adherence was assessed in patients with bacteremia, both those in shock and those not in shock.
- Comparisons were made between patient groups and healthy controls, and the effect of antibiotic therapy and methylprednisolone was examined.
Main Results:
- PMNL adherence was comparable to controls in bacteremic patients not in shock.
- Significantly elevated PMNL adherence was observed in patients 24-36 hours after initiating antibiotic therapy for bacteremia.
- Patients with bacteremic shock exhibited markedly augmented PMNL adherence, which was also observed when normal PMNLs were exposed to plasma from hypotensive patients.
- Methylprednisolone administration reduced PMNL adherence in bacteremic patients.
Conclusions:
- PMNL adherence to nylon is significantly enhanced in patients with bacteremia, especially those progressing to shock.
- The whole-blood PMNL adherence assay is a simple and potentially valuable tool for identifying bacteremic patients at risk of developing shock.
- These findings suggest PMNL adherence could serve as a biomarker for predicting shock in bacteremia.