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Neutrophil dysfunction and increased susceptibility to infection
L Ottonello1, P Dapino, G Pastorino
1Department of Internal Medicine, University of Genova Medical School, Italy.
European Journal of Clinical Investigation
|September 1, 1995
Summary
Laboratory screening identified neutrophil dysfunction in patients with recurrent infections. Impaired chemotaxis was common, suggesting a need for improved diagnostic tests and molecular evaluation for better patient management.
Area of Science:
- Immunology
- Hematology
- Clinical Diagnostics
Background:
- Recurrent bacterial infections can indicate underlying neutrophil dysfunction.
- Accurate diagnosis of neutrophil functional defects is crucial for effective treatment.
Purpose of the Study:
- To evaluate the utility of laboratory screening tests in diagnosing neutrophil dysfunction over three years.
- To identify common neutrophil functional defects in patients with recurrent infections.
Main Methods:
- Assessed neutrophil chemotaxis, superoxide anion (O2-) production, and cytochemical staining in 100 patients.
- Utilized N-formylmethionyl peptides (FMLP) and complement fragment C5a for chemotaxis assays.
- Stimulated O2- production using phorbol myristate acetate and opsonized zymosan particles.
Main Results:
- Identified distinct neutrophil dysfunction syndromes in a minority of patients (e.g., chronic granulomatous disease).
- Found impaired chemotaxis or partial O2- production defects in 53 of 94 patients with localized infections.
- Observed frequent chemotaxis defects towards FMLP and/or C5a, and noted chemotaxis impairment in selective IgA deficiency and immotile cilia syndrome.
Conclusions:
- Current laboratory screening effectively identifies some severe neutrophil dysfunction syndromes.
- Additional screening tests are needed to improve diagnostic efficiency for suspected neutrophil dysfunction.
- Further molecular-level evaluation is recommended for unclassified cases to refine diagnosis and therapeutic strategies.