Acute alcohol exposure has an independent impact on C-reactive protein levels, neutrophil CD64 expression, and subsets of circulating white blood cells differentiated by flow cytometry in nontrauma patients.
Acute and massive alcohol exposure (blood alcohol concentration of ≥1 g/L) is a common way to consume alcohol. In a prospective study performed in critically ill nontrauma patients, we compared C-reactive protein (CRP) values, circulating subsets of white blood cells, and neutrophil CD64 indexes recorded at admission to the intensive care unit between abstinent or moderate drinkers (n = 173), patients with acute or chronic alcohol exposure (n = 32), and patients with acute exposure but not chronically exposed to alcohol (n = 27). Values for CRP (P < 0.001), circulating neutrophils (P < 0.001), and neutrophil CD64 indexes (P < 0.001) were significantly lower in patients acutely exposed compared with the other patients, whereas values for B lymphocytes (P < 0.001) and cytotoxic (P < 0.001) and noncytotoxic T lymphocytes (P < 0.001) were significantly higher. After multiple regression analysis, alcohol exposure remained independently associated with values of CRP, neutrophils CD4 indexes, cytotoxic and noncytotoxic T lymphocytes, and CD16-negative and -positive monocytes. These results were not affected by the presence or absence of infection at admission. Our results suggest that in nontrauma critically ill patients, acute alcohol exposure diminishes inflammation and increases numbers of circulating B and T lymphocytes.
*CHU Rennes, Maladies Infectieuses et Réanimation Médicale; †Inserm-CIC; ‡Univ Rennes 1, Faculté de Médecine, Biosit; §CHU Rennes, Laboratoire d'Hématologie; and ∥Inserm U 917, Rennes, France.
Arnaud
A
Gacouin
Mikael
M
Roussel
Jerome
J
Le Priol
Imane
I
Azzaoui
Fabrice
F
Uhel
Thierry
T
Fest
Yves
Y
Le Tulzo
Jean Marc
JM
Tadie
D056704:Adaptive Immunity / Q000187:drug effects; D000328:Adult; D000368:Aged; D064829:Alcohol Abstinence; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000097:blood / Q000276:immunology / Q000401:mortality; D000437:Alcoholism / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000401:mortality; D063425:Binge Drinking / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002469:Cell Separation / Q000379:methods*; D016638:Critical Illness; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000009:adverse effects* / Q000097:blood; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017452:Receptors, IgG / Q000097:blood*; D012307:Risk Factors
D015415:Biomarkers; D017452:Receptors, IgG; D000431:Ethanol; D002097:C-Reactive Protein