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Leukocyte function assessed via serial microlitre sampling of peripheral blood from sepsis patients correlates with disease severity.
Nature Biomedical Engineering ( IF 28.1 ) Pub Date : 2019-11-11 , DOI: 10.1038/s41551-019-0473-5
Bakr Jundi 1 , Hyunryul Ryu 2 , Do-Hyun Lee 2 , Raja-Elie E Abdulnour 1 , Braden D Engstrom 1 , Melody G Duvall 1 , Angelica Higuera 1 , Mayra Pinilla-Vera 1 , Maura E Benson 3 , Jaemyon Lee 2 , Nandini Krishnamoorthy 1 , Rebecca M Baron 1 , Jongyoon Han 2 , Joel Voldman 2 , Bruce D Levy 1
Affiliation  

Dysregulated leukocyte responses underlie the pathobiology of sepsis, which is a leading cause of death. However, measures of leukocyte function are not routinely available in clinical care. Here we report the development and testing of an inertial microfluidic system for the label-free isolation and downstream functional assessment of leukocytes from 50 μl of peripheral blood. We used the system to assess leukocyte phenotype and function in serial samples from 18 hospitalized patients with sepsis and 10 healthy subjects. The sepsis samples had significantly higher levels of CD16dim and CD16- neutrophils and CD16+ 'intermediate' monocytes, as well as significantly lower levels of neutrophil-elastase release, O2- production and phagolysosome formation. Repeated sampling of sepsis patients over 7 days showed that leukocyte activation (measured by isodielectric separation) and leukocyte phenotype and function were significantly more predictive of the clinical course than complete-blood-count parameters. We conclude that the serial assessment of leukocyte function in microlitre blood volumes is feasible and that it provides significantly more prognostic information than leukocyte counting.

中文翻译:

通过败血症患者外周血的连续微升采样评估的白细胞功能与疾病严重程度相关。

白细胞反应失调是败血症的病理生物学基础,败血症是导致死亡的主要原因。但是,在临床护理中不能常规获得白细胞功能的测量指标。在这里,我们报告开发和测试的惯性微流控系统,用于从50μl外周血中无标记的白细胞的分离和下游功能评估。我们使用该系统评估了18名住院的脓毒症患者和10名健康受试者的系列样本中的白细胞表型和功能。败血症样品的CD16dim和CD16-中性粒细胞和CD16 +“中间”单核细胞水平显着较高,并且中性粒细胞弹性蛋白酶释放,O2产生和吞噬溶酶体形成水平显着降低。对败血症患者进行7天的重复采样显示,白血球活化(通过等电分离测量)以及白血球表型和功能比全血细胞计数参数对临床病程的预测性更高。我们得出的结论是,微升血容量中白细胞功能的系列评估是可行的,并且比白细胞计数可提供更多的预后信息。
更新日期:2019-11-13
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