Neutrophil CD64 expression is associated with severity and prognosis of disseminated intravascular coagulation.
BACKGROUND
Although neutrophil can be activated by microcirculatory disturbances in DIC, its relation with the severity and prognosis of DIC has not been elucidated. We investigated the relationship between neutrophil activation and DIC severity and determined the prognostic value of neutrophil activation markers in patients with DIC.


METHODS
We measured two neutrophil activation markers, neutrophil CD64 expression and plasma neutrophil elastase, in 94 patients with suspected DIC and 55 healthy controls. Neutrophil CD64 expression and plasma neutrophil elastase were measured using CD64 quantitation kit, and PMN Elastase enzyme immunoassay kit.


RESULTS
Neutrophil CD64 expression and plasma neutrophil elastase level were significantly increased in patients with overt and non-overt DIC compared to normal controls (P<0.001, each). Neutrophil CD64 expression showed a significant linear trend of increase with increasing DIC score (P<0.001). In DIC patients, significant differences were observed between those with and without infection both in overt (P=0.003) and non-overt DIC (P=0.004). Neutrophil CD64 expression was significantly increased in 28-day non-survival group compared to survival group in both overt (P<0.001) and non-overt DIC (P=0.032). The 28-day survival rate showed a stronger association with the neutrophil CD64 expression (P<0.001) than with DIC score (P=0.028) or plasma neutrophil elastase level (P=0.246).


CONCLUSIONS
Neutrophil CD64 expression is significantly correlated with DIC severity and has a good predictive value for the 28-day mortality in patients suspected of having DIC. Neutrophil CD64 expression might be useful in monitoring the disease course and in predicting mortality in DIC patients.
Song
Sang Hoon
SH
Department of Laboratory Medicine, Seoul National University, College of Medicine, Seoul, Korea.
Kim
Hyun Kyung
HK
Park
Myoung Hee
MH
Cho
Han-Ik
HI
D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000401:mortality; D005260:Female; D006801:Humans; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000737:chemistry*; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000097:blood; D017452:Receptors, IgG / Q000097:blood*; D000098902:CD163 Antigen
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D000098902:CD163 Antigen; D011956:Receptors, Cell Surface; D017452:Receptors, IgG; D019272:Leukocyte Elastase