Research article
Lymphocyte and monocyte flow cytometry immunophenotyping as a diagnostic
tool in uncharacteristic inflammatory disorders
Helena Janols (http://www.biomedcentral.com/logon/logon.asp?msg=ce) ,
Anders Bredberg (http://www.biomedcentral.com/logon/logon.asp?msg=ce) , Irene
Thuvesson (http://www.biomedcentral.com/logon/logon.asp?msg=ce) , Sabina
Janciauskiene (http://www.biomedcentral.com/logon/logon.asp?msg=ce) , Olof
Grip (http://www.biomedcentral.com/logon/logon.asp?msg=ce) and Marlene
Wullt (http://www.biomedcentral.com/logon/logon.asp?msg=ce)
BMC Infectious Diseases 2010, 10:205doi:10.1186/1471-2334-10-205
Published:
13 July 2010
Abstract (provisional)
Background
Patients with uncharacteristic inflammatory symptoms such as long-standing
fatigue or pain, or a prolonged fever, constitute a diagnostic and
therapeutic challenge. The aim of the present study was to determine if an extended
immunophenotyping of lymphocytes and monocytes including activation
markers can define disease-specific patterns, and thus provide valuable
diagnostic information for these patients.
Methods
Whole blood from patients with gram-negative bacteraemia, neuroborreliosis,
tuberculosis, acute mononucleosis, influenza or a systemic autoimmune
disease, as diagnosed by routine culture and serology techniques was analysed
for lymphocyte and monocyte cell surface markers using a no-wash, no-lyse
protocol for multi-colour flow cytometry method. The immunophenotyping
included the activation markers HLA-DR and CD40. Plasma levels of soluble TNF
alpha receptors were analysed by ELISA.
Results
An informative pattern was obtained by combining two of the analysed
parameters: (i), the fractions of HLA-DR-expressing CD4+ T cells and CD8+ T
cells, respectively, and (ii), the level of CD40 on CD14+ CD16- monocytes.
Patients infected with gram-negative bacteria or EBV showed a marked increase in
monocyte CD40, while this effect was less pronounced for tuberculosis,
borrelia and influenza. The bacterial agents could be distinguished from the
viral agents by the T cell result; CD4+ T cells reacting in bacterial
infection, and the CD8+ T cells dominating for the viruses. Patients with
systemic autoimmunity also showed a increased activation, but with similar
engagement of CD4+ and CD8+ T cells. Analysis of soluble TNF alpha receptors was
less informative due to a large inter-individual variation.
Conclusion
Immunophenotyping including the combination of the fractions of HLA-DR
expressing T cell subpopulations with the level of CD40 on monocytes produces
an informative pattern, differentiating between bacterial origin, viral
origin and systemic autoimmunity. Furthermore, it provides some indication of a
subacute bacterial infection, such as borreliosis or tuberculosis. This
flow cytometric method is suitable for clinical diagnostic laboratories, and
may help in the assessment of patients with uncharacteristic inflammatory
symptoms.
The complete article is available as a _provisional PDF_
(http://www.biomedcentral.com/content/pdf/1471-2334-10-205.pdf) . The fully formatted PDF and
HTML versions are in production.
(These are Swedish and German authors, and article is open access, free
full text)
[Non-text portions of this message have been removed]
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