Vlková Marcela, Štíchová Julie, Surá Karolína, Dvořáková Karolína, Kunčický Vojtěch, Papatheodorou Ioanna, Blažková Gabriela, Tomášiková Zuzana, Bendíčková Kamila, Dohnálková Ludmila, Mýtniková Alexandra, Žák Jan, Kovařík Jan, Krtička Milan, Tomáš Tomáš, Šrámek Vladimír, Helán Martin, Kocurková Anna, Frič Jan, Hortová-Kohoutková Marcela
Institute of Clinical Immunology and Allergology, Faculty of Medicine, Masaryk University, Brno, Czechia.
Institute of Clinical Immunology and Allergology, St. Anne's University Hospital, Brno, Czechia.
Front Immunol. 2025 Jul 8;16:1565606. doi: 10.3389/fimmu.2025.1565606. eCollection 2025.
Trauma is a leading global cause of mortality, and systemic inflammatory response syndrome (SIRS) remains a significant complication, contributing to adverse outcomes. Neutrophils, as first responders to tissue injury, undergo substantial phenotypic and functional changes following trauma. This study investigates neutrophil subpopulations defined by CD16 and CD62L expression in trauma patients, focusing on their correlation with clinical biomarkers, trauma severity, and functional properties.
We included 50 non-infectious trauma patients, categorized into SIRS and Non-SIRS groups, and 43 elective surgery patients as controls. Neutrophil subsets were analyzed at two time points (TP1 and TP2) using flow cytometry. Functional assays evaluated phagocytosis, oxidative burst, mitochondrial function, and degranulation. Correlations between neutrophil subpopulations and clinical markers, including lactate, creatine kinase, Injury Severity Score, and Trauma and Injury Severity Score, were examined.
Patients with SIRS exhibited higher proportions of banded neutrophils and CD16CD62L neutrophils at TP1, alongside reduced levels of mature neutrophils. Elevated lactate and creatine kinase levels positively correlated with banded neutrophils and CD16CD62L neutrophils, while negatively correlating with mature neutrophils CD16CD62L and hypersegmented neutrophils CD16CD62L. Hypersegmented neutrophils were more prevalent in Non-SIRS patients at TP1 and in SIRS patients at TP2. Banded neutrophils showed a positive correlation with Injury Severity Score and an inverse correlation with Trauma and Injury Severity Score (TRISS), whereas hypersegmented neutrophils were negatively associated with ISS and positively correlated with TRISS. These correlations likely reflect the pro-inflammatory role of banded neutrophils and the inflammation-resolving function of hypersegmented neutrophils. CD16CD62L neutrophils displayed impaired phagocytosis, oxidative burst, and degranulation capacity, indicating functional deficiencies.
This study highlights the dynamic changes in neutrophil subpopulations in trauma and their association with systemic inflammation and clinical severity. Increased banded neutrophils correlate with SIRS and metabolic stress, whereas hypersegmented neutrophils may contribute to resolving inflammation. CD16CD62L neutrophils exhibit functional impairments, warranting further investigation. Monitoring neutrophil subpopulations could aid in identifying trauma patients at risk for non-infectious SIRS and guide therapeutic interventions.
创伤是全球主要的死亡原因，全身炎症反应综合征（SIRS）仍然是一个重要的并发症，会导致不良后果。中性粒细胞作为组织损伤的第一反应者，在创伤后会发生显著的表型和功能变化。本研究调查了创伤患者中由CD16和CD62L表达定义的中性粒细胞亚群，重点关注它们与临床生物标志物、创伤严重程度和功能特性的相关性。
我们纳入了50例非感染性创伤患者，分为SIRS组和非SIRS组，以及43例择期手术患者作为对照组。使用流式细胞术在两个时间点（TP1和TP2）分析中性粒细胞亚群。功能测定评估吞噬作用、氧化爆发、线粒体功能和脱颗粒。检查中性粒细胞亚群与临床标志物之间的相关性，包括乳酸、肌酸激酶、损伤严重度评分以及创伤和损伤严重度评分（TRISS）。
SIRS患者在TP1时带状中性粒细胞和CD16⁺CD62L⁻中性粒细胞比例较高，同时成熟中性粒细胞水平降低。乳酸和肌酸激酶水平升高与带状中性粒细胞和CD16⁺CD62L⁻中性粒细胞呈正相关，而与成熟中性粒细胞CD16⁺CD62L⁺和分叶过多中性粒细胞CD16⁺CD62L⁺呈负相关。分叶过多中性粒细胞在TP1时在非SIRS患者中更常见，在TP2时在SIRS患者中更常见。带状中性粒细胞与损伤严重度评分呈正相关，与创伤和损伤严重度评分（TRISS）呈负相关，而分叶过多中性粒细胞与损伤严重度评分呈负相关，与TRISS呈正相关。这些相关性可能反映了带状中性粒细胞的促炎作用和分叶过多中性粒细胞的炎症消退功能。CD16⁺CD62L⁻中性粒细胞表现出吞噬作用、氧化爆发和脱颗粒能力受损，表明存在功能缺陷。
本研究强调了创伤中中性粒细胞亚群的动态变化及其与全身炎症和临床严重程度的关联。带状中性粒细胞增加与SIRS和代谢应激相关，而分叶过多中性粒细胞可能有助于炎症消退。CD16⁺CD62L⁻中性粒细胞表现出功能障碍，值得进一步研究。监测中性粒细胞亚群有助于识别有非感染性SIRS风险的创伤患者并指导治疗干预。
