Does Neutrophil Phenotype Predict the Survival of Trauma Patients?

Abstract

According to the World Health Organization (WHO), trauma is responsible for 10% of deaths and 16% of disabilities worldwide. This is considerably higher than those for malaria, tuberculosis, and HIV/AIDS combined. While the human suffering and death caused by injury is well-recognized, injury has a significant medical care cost. Better prediction of the state of trauma patients in the days immediately after trauma may reduce costs. Traumatic injuries to multiple organs can cause dysfunction in all systems of the body especially the immune system placing patients at high risk of infections and inflammatory complications which are often fatal. Neutrophils are the most abundant leukocyte in the human circulation and are crucial for the prevention of microbial disease. Significant changes in neutrophil functions such as enhanced chemotaxis, Neutrophil extracellular trap (NET)-induced cell death (NETosis), and phagocytosis occur early after injury followed by prolonged functional defects such as phagocytosis, killing mechanisms, and receptor expression. Analysis of these changes may improve the prediction of the patient's condition over time. We provide a comprehensive and up-to-date review of the literature investigating the effect of trauma on neutrophil phenotype with an underlying goal of using this knowledge to examine the predictive potential of neutrophil alterations on secondary complications in patients with traumatic injuries. We conclude that alterations in neutrophil surface markers and functions may be potential biomarkers that predict the outcome of trauma patients.

Persistent Systemic Inflammation in Patients With Severe Burn Injury Is Accompanied by Influx of Immature Neutrophils and Shifts in T Cell Subsets and Cytokine Profiles

“…We also observed reduced CD16 expression on immature neutrophils (data not shown). It has been shown that continuous release of neutrophils into the circulation can lead to bone marrow exhaustion that in turn can lead to compromised innate immunity (38)(39)(40). Although literature on the functions or activities of immature neutrophils is conflicting, some papers state that immature neutrophils are underdeveloped and that high numbers and their active state might induce tissue damage causing secondary progression of the burn injury (13,38,39).…”

New automated analysis to monitor neutrophil function point-of-care in the intensive care unit after trauma

“…Generally used biomarkers such as leukocyte counts and C-reactive protein (CRP) become positive during infections and therefore have limited prognostic value [7]. Since neutrophils are the first responders to both tissue damage and invading pathogens [8,9], multiple studies focused on neutrophils as potential biomarkers [10][11][12][13][14][15][16]. Biomarkers that were suggested after trauma included neutrophil C5aR expression [13,14], neutrophil extracellular traps (NETs) [17], neutrophil CD64 expression [18,19], neutrophil cell size [20], and neutrophil formyl-methionyl-leucyl-phenylalanine (fMLF)-induced FcγRII expression, of which only the latter was found to be an early marker in multiple trauma cohorts [21,22].…”

Il-1Β Primed Mesenchymal Stromal Cells Moderate Hemorrhagic Shock Induced Organ Injuries

“…Systemic IL-6 and IL-10 cytokines were early up-regulated in SIRS/CARS pathology (28). In this context, IL-6 is usually correlated with mortality and can be a used as biomarker to identify patients at risk of developing MODS after trauma (30). We observed that HS induced an up-regulation of these pro and antiin ammatory cytokines.…”

“…MSCp infusion decreased IL-6 and IL-10 plasma levels. Granulocytes are important mediators of in ammation-induced injury (30) as well as monocytes that also contribute to both innate and adaptive immune suppression (31,32). Moreover, a body of recent evidence demonstrates that under pathological or in ammatory conditions, granulocytes can acquire the function of antigen presenting cells.…”