Jindal Saumya, Gupta Richa, Dewan Pooja, Kotru Mrinalini, Gogoi Priyanka, Doodani Priyank
Department of Pathology, University College of Medical Sciences Dilshad Garden, Delhi 110095, India.
Department of Paediatrics, University College of Medical Sciences Dilshad Garden, Delhi 110095, India.
Am J Blood Res. 2025 Apr 25;15(2):31-39. doi: 10.62347/CIUH6314. eCollection 2025.
Failure to thrive (FTT) refers to failure of expected weight gain, striking lack of well-being and inadequate physical growth in children. The causes vary with geographical and socio-economic factors. In developed countries, FTT is usually a symptom of an underlying disease, often a gastrointestinal or neurological disorder. However, in developing countries, FTT is often associated with inadequate caloric intake and malnutrition. Such children are at an increased risk of infections and infection-related mortality which may be related to altered immune responses. Rarely some Primary immunodeficiencies (PIDs) can manifest as FTT. Not much data regarding neutrophil functions in these children is available.
The present study aimed to analyse the functional activity of neutrophils in children with FTT using a highly sensitive and specific flow cytometry-based assay.
25 children with FTT (up to 5 years) and 25 healthy controls were assessed for haematological parameters and neutrophil oxidative burst activity by DHR Assay using Flow cytometry.
Compared to controls, the cases had significantly lower haemoglobin, hematocrit, RBC count and MCHC but a higher eosinophil count (). On flow cytometry, the Neutrophil Oxidative Index (NOI) was significantly reduced in cases (). 1 of 25 cases (4%) showed no change in neutrophil fluorescence after stimulation, suggesting the presence of CGD, which was later confirmed with molecular assay revealing a CYBB mutation.
To conclude, children with FTT have a decreased Neutrophil Oxidative Burst, suggesting defective killing of pathogens by phagocytes. Also, the presence of CGD should be ruled out in such children.
发育不良（FTT）是指儿童预期体重增加失败、明显缺乏健康状态以及身体生长不足。其病因因地理和社会经济因素而异。在发达国家，FTT通常是潜在疾病的症状，常见的是胃肠道或神经系统疾病。然而，在发展中国家，FTT往往与热量摄入不足和营养不良有关。这类儿童感染及感染相关死亡率增加，这可能与免疫反应改变有关。极少数情况下，一些原发性免疫缺陷病（PID）可表现为FTT。关于这些儿童中性粒细胞功能的数据不多。
本研究旨在使用基于高灵敏度和特异性流式细胞术的检测方法，分析发育不良儿童中性粒细胞的功能活性。
对25名发育不良儿童（5岁及以下）和25名健康对照者进行血液学参数评估，并使用流式细胞术通过DHR检测法检测中性粒细胞氧化爆发活性。
与对照组相比，病例组的血红蛋白、血细胞比容、红细胞计数和平均红细胞血红蛋白浓度显著降低，但嗜酸性粒细胞计数较高（）。流式细胞术检测显示，病例组的中性粒细胞氧化指数（NOI）显著降低（）。25例中有1例（4%）在刺激后中性粒细胞荧光无变化，提示存在慢性肉芽肿病（CGD），随后通过分子检测证实存在CYBB突变。
总之，发育不良儿童的中性粒细胞氧化爆发降低，提示吞噬细胞杀灭病原体的功能存在缺陷。此外，此类儿童应排除CGD的存在。
