Fernandez Gabriela C, Gomez Sonia A, Ramos Maria V, Bentancor Leticia V, Fernandez-Brando Romina J, Landoni Veronica I, Lopez Laura, Ramirez Flavia, Diaz Mario, Alduncin Marta, Grimoldi Irene, Exeni Ramon, Isturiz Martin A, Palermo Marina S
Division of Immunology, Institute of Hematological Investigations, National Academy of Medicine, C1425AUM Buenos Aires, Argentine.
Pediatr Res. 2007 Jan;61(1):123-8. doi: 10.1203/01.pdr.0000250037.47169.55.
Hemolytic Uremic Syndrome (HUS) is the main cause of acute renal failure in children. The high percentage of patients who develop long-term sequelae constitutes an important medical concern. The identification of parameters that correlate with the degree of renal failure may be useful to plan the best treatment soon after hospitalization. Here, we investigated the functional state of neutrophils (PMN) from HUS patients on admission, before dialysis and/or transfusion, in relation to the severity of renal impairment reached during the acute period (AP). We found that all PMN activation parameters measured in severe cases of HUS (HUS AP3) were statistically lower comparing to children with mild cases of HUS (HUS AP1). As HUS PMN phenotype and dysfunction is compatible with that of cells undergoing cell death, we also studied spontaneous apoptosis. Not only were HUS PMN not apoptotic, but HUS AP3 PMN showed an increased survival. Almost all phenotypic and functional parameters measured on PMN correlated with severity. Our results revealed a marked deactivation of PMN in severe cases of HUS, and suggest that studying the functional state of PMN could be of prognostic value.
溶血性尿毒症综合征（HUS）是儿童急性肾衰竭的主要原因。出现长期后遗症的患者比例很高，这构成了一个重要的医学问题。识别与肾衰竭程度相关的参数可能有助于在患者住院后尽快规划最佳治疗方案。在此，我们研究了HUS患者在入院时、透析和/或输血前中性粒细胞（PMN）的功能状态，以及与急性期（AP）达到的肾功能损害严重程度之间的关系。我们发现，与轻度HUS病例（HUS AP1）的儿童相比，在严重HUS病例（HUS AP3）中测量的所有PMN激活参数在统计学上都较低。由于HUS PMN的表型和功能障碍与经历细胞死亡的细胞相符，我们还研究了自发凋亡。HUS PMN不仅没有凋亡，而且HUS AP3 PMN的存活率增加。在PMN上测量的几乎所有表型和功能参数都与严重程度相关。我们的结果显示，严重HUS病例中PMN明显失活，并表明研究PMN的功能状态可能具有预后价值。
