Stelmaszczyk-Emmel Anna, Sosnowska Anna, Kurkowiak Justyna, Sagała Magdalena, Zawadzka-Głos Lidia, PyrŻak Beata, Demkow Urszula
Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland.
Student's Scientific Group at the Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland.
Cent Eur J Immunol. 2018;43(3):262-269. doi: 10.5114/ceji.2018.80044. Epub 2018 Oct 30.
Accurate diagnosis of bacterial and viral infection is very difficult. Unfortunately, there is still no quick and discriminative diagnostic test that would help clinicians in establishing the diagnosis and taking a decision on treatment. The aim of the study was to compare the expression of antigens on phagocytes, which are involved in the first defence line during bacterial and viral infections in children, as a potential tool to distinguish the etiology of the infection.
The expression of CD35, CD32, CD88, and MHC class I on phagocytes in 49 blood samples from children with high fever and suspected infection as well as 19 healthy children (control group) was assessed by flow cytometry. Thirty-three children were diagnosed with bacterial and 16 with viral infection. Expression of antigens was analysed on a FACSCanto II flow cytometer according to mean fluorescence intensity (MFI) and antibody binding cites (ABC).
Significant differences were observed for the following: CD32, CD35, CD88, and MHCI on granulocytes; CD32, CD35, CD88 on monocytes; and MHC-I ratio between groups were observed. The obtained results did not allow us to establish valuable score points for distinguishing between bacterial and viral infections. Classification and a regression tree using CD88 expression on granulocytes and CRP was developed. It enabled us to differentiate between the origin of infection with sensitivity and specificity of more than 90%.
Utility of use of wide range antigens' expression on phagocytes for distinguishing between bacterial and viral infection in children has limited value. More adequate seems to be use of CD88 expression on granulocytes linked with CRP value.
准确诊断细菌和病毒感染非常困难。不幸的是，目前仍没有快速且具有鉴别性的诊断测试能够帮助临床医生进行诊断并决定治疗方案。本研究的目的是比较吞噬细胞上抗原的表达情况，这些吞噬细胞参与儿童细菌和病毒感染期间的第一道防线，作为区分感染病因的潜在工具。
通过流式细胞术评估了49例高热且疑似感染儿童的血液样本以及19例健康儿童（对照组）吞噬细胞上CD35、CD32、CD88和MHC I类分子的表达。33名儿童被诊断为细菌感染，16名儿童被诊断为病毒感染。根据平均荧光强度（MFI）和抗体结合位点（ABC），在FACSCanto II流式细胞仪上分析抗原的表达。
观察到以下方面存在显著差异：粒细胞上的CD32、CD35、CD88和MHCI；单核细胞上的CD32、CD35、CD88；以及各组之间的MHC-I比率。所得结果无法让我们确定区分细菌和病毒感染的有价值的评分点。利用粒细胞上CD88的表达和CRP建立了分类与回归树。它使我们能够以超过90%的敏感性和特异性区分感染的来源。
利用吞噬细胞上广泛抗原的表达来区分儿童细菌和病毒感染的实用性有限。将粒细胞上CD88的表达与CRP值结合使用似乎更为合适。
