title: Expression of CD11c and EMR2 on neutrophils: potential diagnostic biomarkers for sepsis and systemic inflammation.
abstract: There is a need for cellular biomarkers to differentiate patients with sepsis from those with the non-infectious systemic inflammatory response syndrome (SIRS). In this double-blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)-like molecule containing mucin-like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non-infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0.001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0.05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively.
authors.affiliation: Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.|Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London.
authors.forename: S M
authors.initials: SM
authors.lastname: Lewis
authors.affiliation: Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.
authors.forename: D F
authors.initials: DF
authors.lastname: Treacher
authors.affiliation: Department of Infection, Guy's and St Thomas' NHS Foundation Trust, University of Leeds, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Edgeworth
authors.affiliation: Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London.
authors.forename: G
authors.initials: G
authors.lastname: Mahalingam
authors.affiliation: Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.
authors.forename: C S
authors.initials: CS
authors.lastname: Brown
authors.affiliation: Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.|Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London.
authors.forename: T A
authors.initials: TA
authors.lastname: Mare
authors.affiliation: School of Molecular and Cellular Biology, University of Leeds, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Stacey
authors.affiliation: Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.|Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London.
authors.forename: R
authors.initials: R
authors.lastname: Beale
authors.affiliation: Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.|Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London.
authors.forename: K A
authors.initials: KA
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D039521:CD11c Antigen / Q000097:blood* / Q000276:immunology; D003937:Diagnosis, Differential; D004311:Double-Blind Method; D005260:Female; D005434:Flow Cytometry; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000378:metabolism*; D043562:Receptors, G-Protein-Coupled / Q000097:blood* / Q000276:immunology; D017452:Receptors, IgG / Q000097:blood / Q000276:immunology; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology
chemical_list: C412456:ADGRE2 protein, human; D015415:Biomarkers; D039521:CD11c Antigen; D043562:Receptors, G-Protein-Coupled; D017452:Receptors, IgG
keywords: biomarkers; diagnosis, neutrophils; sepsis; systemic inflammatory response syndrome