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首页> 外文期刊>Journal of Clinical Medicine Research >Evaluation of the Activity of Neutrophils and Monocytes in Diabetic Patients With Sepsis, Can Surface Antigens HLA-DR and CD64 Be Useful as Prognostic Factors?
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Evaluation of the Activity of Neutrophils and Monocytes in Diabetic Patients With Sepsis, Can Surface Antigens HLA-DR and CD64 Be Useful as Prognostic Factors?

机译：评价患有败血症患者的中性粒细胞和单核细胞的活性，可以表面抗原HLA-DR和CD64可用作预后因素？

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Background:Patients with diabetes mellitus (DM) exhibit alterations in their immune response when infected by several types of micro-organisms. The increased susceptibility of diabetics to infections is particularly related to abnormalities in the function of neutrophils such as chemotaxis, adhesion and intracellular killing, leading to increased mortality rates. Aims of the study were to assess the phagocytic activity and the expression of antigens HLA-DR and CD64 of monocytes and neutrophils in diabetics with sepsis and evaluate their significance as prognostic factors.Methods:This is an observational prospective study conducted in a tertiary medical center, referring to a population of 51 diabetic patients who were treated for sepsis. Samples of whole blood were received from the selected patients and were evaluated for the expression of surface antigens HLA-DR and CD64 on monocytes and neutrophils, and for their phagocytic activity as well.Results:Alterations in the phagocytic activity were found in the diabetic patients who developed sepsis, and these were addressed as an elevation in the expression of CD64 on monocytes (CD64M), and a reduction in the expression of HLA-DR on monocytes (HLA-DRM) at least in the initial phase of the acute infection. A significant elevation was also noticed in the phagocytosis rate of both neutrophils and monocytes on day of admission. Survivors had higher rates of both CD64 and HLA-DR on monocytes when compared to non-survivors. No correlation was found between glycemic control, values of inflammatory markers on admission, phagocytosis rate and the survival of diabetics with sepsis. A reduced expression of CD64O, HLA-DRM and the co-expression of CD64/HLA-DR on monocytes in the initial phase of sepsis and poor glycemic control (hemoglobin A1c (HbA1c) 8.5) was found.Conclusions:In the present study of diabetic patients with sepsis the phagocytic activity of neutrophils and monocytes is elevated at the initial phase of an acute infection and only the values of CD64 and HLA-DR on monocytes were significantly related to outcome. Further evaluation of these results with large prospective studies is warranted.Copyright 2020, Lekka et al.
机译：背景：糖尿病患者（DM）在受几种类型的微生物感染时，在其免疫应答中表现出改变。糖尿病患者对感染的易感性增加尤其是嗜中性粒细胞功能的异常相关，例如趋化性，粘附和细胞内杀灭，导致死亡率增加。该研究的目的是评估吞噬细胞和中性粒细胞在糖尿病患者中的吞噬活性和表达单核细胞和中性粒细胞的表达，并评估其作为预后因素的重要性。方法：这是在第三级医疗中心进行的观察前瞻性研究，参考用于败血症治疗的51名糖尿病患者的群体。从选定的患者接收全血样品，并评估了在单核细胞和中性粒细胞上的表面抗原HLA-DR和CD64的表达，以及它们的吞噬活性。结果：在糖尿病患者中发现了吞噬活性的改变世卫组织开发了败血症，这些是在单核细胞（CD64M）上表达CD64的升高，以及至少在急性感染的初始阶段的单核细胞（HLA-DRM）上的HLA-DR表达的升高。在入院日中，中性粒细胞和单核细胞的吞噬速度也注意到显着升高。与非幸存者相比，幸存者在单核细胞上具有更高的CD64和HLA-DR的速率。血糖控制之间没有发现相关性，炎症标志物的入学，吞噬作用率和脓毒症糖尿病患者存活的价值。发现CD64O，HLA-DRM和CD64 / HLA-DR的CD64 / HLA-DR的CD64 / HLA-DR的CD64 / HLA-DR的CD64 / HLA-DR的共表达酶发现（血红蛋白A1C（HBA1C）> 8.5）中的CD64 / HLA-DR。结论：在本研究中患有脓毒症患者的糖尿病患者中性粒细胞和单核细胞的吞噬活性在急性感染的初始阶段升高，并且只有单核细胞的CD64和HLA-DR的值与结果显着相关。对这些结果进行进一步评估这些结果与大型前瞻性研究是有保证的。柔小岛2020，Lekka等。

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