CD88 and CD64 as markers of sepsis in critical care patients
Research type
Research Study
Full title
Investigation to study the expression of CD88 and CD64 as markers of sepsis in critical care patients.
IRAS ID
140222
Contact name
Chloe Attridge
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS Foundation Trust
Research summary
Critical care unit (CCU) patients are susceptible to hospital-acquired infection. Aggressive, acute immune response to infection frequently appears with concurrent suppression and failure of other immune factors, thought to be due to the impairment of white blood cells, specifically neutrophil and monocyte function in response to infection. These events lead to the increased likelihood of a patient developing sepsis, which is responsible for 37,000 deaths per year in the UK.
Sepsis is difficult to differentiate from tissue injury related systemic inflammatory response syndromes (SIRS). This is due to both being characterised by similar laboratory test anomalies: high white blood cell count (WBC), raised C reactive protein (CRP) and raised serum procalcitonin. Understanding of the active immune processes that result in severe sepsis via specific and sensitive laboratory techniques may allow intervention before fatal organ failure and bleeding and clotting tendencies occur. This is has led to interest in the significance of the expression of WBC neutrophil and monocyte marker CD88 and neutrophil marker CD64 in CCU patients.
The normal role of complement anaphylotoxin C5a is to recruit and activate pathogen destroying cells such as neutrophils and monocytes at sites of infection. However, in sepsis, C5a appears to be overexpressed and impairs immune function via interaction with its receptor, CD88. This results in internalisation of CD88 resulting in decreased expression of CD88 on the surface of neutrophils and monocytes, thought to affect immunity.
Neutrophil surface marker CD64 is a known specific marker of sepsis. Previous studies have shown CCU patients appear to express this marker at higher levels whilst it is minimally expressed by normal neutrophils.This study aims to examine whether reduced expression of CD88 precedes sepsis as indicated by progressively increased expression of CD64 in WBCs of CCU patients over time since admission in CCU compared to normal controls.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
13/LO/1924
Date of REC Opinion
18 Dec 2013
REC opinion
Favourable Opinion