Comins-Boo Alejandra, Gutiérrez-Larrañaga Maria, Roa-Bautista Adriel, Guiral Foz Sandra, Renuncio García Mónica, González López Elena, Irure Ventura Juan, Fariñas-Álvarez María Carmen, San Segundo David, López Hoyos Marcos
Immunology Unit, Marqués de Valdecilla University Hospital, Santander, Spain.
Autoimmunity and Transplantation Research Group, Research Institute "Marqués de Valdecilla" (IDIVAL), Santander, Spain.
Front Med (Lausanne). 2021 Mar 23;8:655785. doi: 10.3389/fmed.2021.655785. eCollection 2021.
Several parameters aid in deciphering between viral and bacterial infections; however, new tools should be investigated in order to reduce the time to results and proceed with an early target-therapy. Validation of a biomarker study, including CD64 and CD169 expression, was conducted. Patients with active SARS-CoV-2 infection (ACov-2), bacterial infection (ABI), healthy controls, and antiretroviral-controlled chronic HIV infection were assessed. Whole blood was stained and, after lysing no-wash protocol, acquired by flow cytometry. The median fluorescence intensity (MFI) of CD64 and CD169 was measured in granulocytes, monocytes, and lymphocytes. The CD64 MFI ratio granulocytes to lymphocytes (CD64N) and CD169 MFI ratio monocytes to lymphocytes (CD169Mo) were evaluated as biomarkers of acute bacterial and viral infection, respectively. A CD64N ratio higher than 3.3 identified patients with ABI with 83.3 and 85.9% sensitivity and specificity, with an area under the curve (AUC) of 83.5%. In contrast, other analytic or hematological parameters used in the clinic had lower AUC compared with the CD64N ratio. Moreover, a CD169Mo ratio higher than 3.3 was able to identify ACov-2 with 91.7 and 89.8 sensitivity and specificity, with the highest AUC (92.0%). This work confirms the previous data of CD64N and CD169Mo ratios in an independent cohort, including controlled chronic viral HIV infection patients as biomarkers of acute bacterial and viral infections, respectively. Such an approach would benefit from quick pathogen identification for a direct-therapy with a clear application in different Health Care Units, especially during this COVID pandemic.
有几个参数有助于区分病毒感染和细菌感染；然而，应研究新的工具，以缩短获得结果的时间并进行早期靶向治疗。开展了一项生物标志物研究的验证工作，包括CD64和CD169表达。对活动性严重急性呼吸综合征冠状病毒2感染（ACov-2）患者、细菌感染（ABI）患者、健康对照者以及抗逆转录病毒治疗控制的慢性HIV感染患者进行了评估。采集全血并进行染色，采用无需洗涤的裂解方案后，通过流式细胞术进行检测。在粒细胞、单核细胞和淋巴细胞中测量CD64和CD169的中位荧光强度（MFI）。分别将粒细胞与淋巴细胞的CD64 MFI比值（CD64N）和单核细胞与淋巴细胞的CD169 MFI比值（CD169Mo）评估为急性细菌感染和病毒感染的生物标志物。CD64N比值高于3.3时，识别ABI患者的灵敏度和特异度分别为83.3%和85.9%，曲线下面积（AUC）为83.5%。相比之下，临床使用的其他分析或血液学参数的AUC低于CD64N比值。此外，CD169Mo比值高于3.3时，识别ACov-2的灵敏度和特异度分别为91.7%和89.8%，AUC最高（92.0%）。这项工作在一个独立队列中证实了先前关于CD64N和CD169Mo比值的数据，包括将慢性病毒HIV感染控制患者分别作为急性细菌感染和病毒感染的生物标志物。这种方法将受益于快速的病原体鉴定，以便进行直接治疗，在不同的医疗保健单位有明确的应用，特别是在当前的新冠疫情期间。
