Neutrophil and monocyte CD64 and CD163 expression in critically ill neonates and children with sepsis: comparison of fluorescence intensities and calculated indexes

Mojca Groselj-Grenc, Alojz Ihan, Metka Derganc, Mojca Groselj-Grenc, Alojz Ihan, Metka Derganc

Abstract

Objective: To evaluate the expression of CD64 and CD163 on neutrophils and monocytes in SIRS with/without sepsis and to compare the diagnostic accuracy of CD64 and CD163 molecules expression determined as (1) mean fluorescence intensities (MFI) of CD64 and CD163; and (2) the ratio (index) of linearized MFI to the fluorescence signal of standardized beads.

Patients and methods: Fifty-six critically ill neonates and children with systemic inflammatory response syndrome (SIRS) and suspected sepsis, classified into two groups: SIRS with sepsis (n = 29) and SIRS without sepsis (n = 27).

Results: CD64 and CD163 MFI measured on neutrophils and monocytes were elevated in patients with SIRS with sepsis. Diagnostic accuracy of indexes was equal to diagnostic accuracy of MFI for CD64 on neutrophils (0.833 versus 0.854 for day 0 and 0.975 versus 0.983 for day 1) and monocytes (0.811 versus 0.865 for day 0 and 0.825 versus 0.858 for day 1), and CD163 on neutrophils (0.595 versus 0.655 for day 0 and 0.677 versus 0.750 for day 1), but not for CD163 on monocytes.

Conclusion: CD64 MFI, CD163 MFI, CD64 indexes for neutrophils and monocytes, and CD163 index for neutrophils can all be used for discrimination of SIRS and sepsis in critically ill neonates and children. CD64 index for neutrophils, however, is superior to all other markers.

Figures

Figure 1
Figure 1
Gating of neutrophils, monocytes, and lymphocytes in FSC/SSC representative FACS diagrams. CD64 and CD163 histograms (colored) versus CD64 isotype controls (lined) are presented for granulocytes (red), lymphocytes (green), and monocytes (blue).
Figure 2
Figure 2
CD64 indexes for neutrophils at the time of suspected sepsis (day 0), and 24 hours later (day 1), for separate groups of neonates and children. Data are presented as box plots (median value and interquartile range). Outliers and extreme cases of index CD64 are not shown.
Figure 3
Figure 3
Receiver-operating characteristic (ROC) curves of CD64 and CD163 indexes (i) for neutrophils and monocytes for critically ill neonates and children with SIRS with sepsis and SIRS without sepsis at the time of suspected sepsis (day 0) and 24 hours later (day 1).

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