title: Increased EMR2 expression on neutrophils correlates with disease severity and predicts overall mortality in cirrhotic patients.
abstract: Patients with liver cirrhosis are susceptible to infections with high short-term mortalities. One CD97-related EGF-TM7 molecule, EMR2 (EGF-like molecule containing mucin-like hormone receptor 2), had been shown to regulate human neutrophil function, potentiate systemic inflammation. Nevertheless, EMR2 could also suppress neutrophil survival. Studying the role of EMR2 on neutrophil would be intriguing. 48 healthy volunteers and 100 cirrhotic patients were enrolled. Neutrophils were isolated from peripheral blood and cell surface markers were measured by flow cytometry.EMR2 expression levels correlated with CTP scores and increased further in patients with infections. These EMR2-expressed neutrophils were with activated phenotype, but with deranged functions like increased resting oxidative burst and impaired phagocytosis ability. Ligation of EMR2 could increase the phagoburst capacity but not the phagocytosis ability. Furthermore, neutrophils with higher EMR2 expression were more apoptotic and lost the LPS-induced neutrophil survival. Finally, EMR2 expressions on neutrophils correlated with infections and their levels greater than 25 had an AUC = 0.708 for predicting mortality. In conclusion, EMR2 expression levels correlated with CTP scores and increased further in cirrhotic patients with infections. These high EMR2-expressed neutrophils had activated phenotype but with deranged functions. Higher levels of these EMR2-expressed neutrophils correlated with infectious complications and predict mortality.
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Chien-Hao
authors.initials: CH
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.
authors.forename: Wen-Juei
authors.initials: WJ
authors.lastname: Jeng
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.
authors.forename: Yu-Pin
authors.initials: YP
authors.lastname: Ho
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.
authors.forename: Wei-
authors.initials: W
authors.lastname: Teng
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.
authors.forename: Yi-Chung
authors.initials: YC
authors.lastname: Hsieh
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.|School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333, Taiwan.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.|Chang Guang Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan 333, Taiwan.|Department of Anatomic Pathology, Chang Gung Memorial Hospital- Linkou, Taoyuan 333, Taiwan.
authors.forename: Hsi-Hsien
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.|School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333, Taiwan.
authors.forename: I-Shyan
authors.initials: IS
authors.lastname: Sheen
authors.affiliation: Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan.|School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333, Taiwan.
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D007239:Infections / Q000097:blood / Q000401:mortality / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism* / Q000473:pathology; D043562:Receptors, G-Protein-Coupled / Q000097:blood*; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: C412456:ADGRE2 protein, human; D043562:Receptors, G-Protein-Coupled