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      Better chance of survival is associated with higher neutrophil CD16 expression in patients with complicated intra-abdominal infections

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          Abstract

          Aim

          The ability of neutrophil CD16 (nCD16) expression to predict outcome in complicated intra-abdominal infections (cIAIs) has not yet been studied; therefore we aimed to evaluate its potential prognostic value in such patients.

          Methods

          Between November 2018 and August 2021 a single-center prospective study was performed in the Department of Surgical Diseases at a University Hospital Stara Zagora. A flow cytometry was used to measure the levels of nCD16 before surgery and on the 3rd postoperative day (POD) in 62 patients with cIAIs.

          Results

          We observed a mortality rate of 14.5% during hospitalization. Survivors had significantly higher perioperative expression of nCD16 than non-survivors ( P = 0.02 preoperatively and P = 0.006 postoperatively). As predictor of favorable outcome we found a good predictive performance of preoperative nCD16 (AUROC = 0.745) and a very good predictive performance of postoperative levels (AUROC = 0.846). An optimal preoperative threshold nCD16 = 34.75 MFI permitted prediction of survival with sensitivity and specificity of 66.7% and 77.8%, respectively. A better sensitivity of 72.5% and specificity of 85.7% were observed for threshold = 54.8 MFI on the 3rd POD.

          Conclusion

          Perioperative neutrophil CD16 expression shows a great potential as a predictor of favorable outcome in patients with cIAIs.

          Most cited references34

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          Sepsis: pathophysiology and clinical management

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            The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

            Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.
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              Complement activation induces excessive T cell cytotoxicity in severe COVID-19

              Severe COVID-19 is linked to both dysfunctional immune response and unrestrained immunopathology, and it remains unclear whether T cells contribute to disease pathology. Here, we combined single-cell transcriptomics and single-cell proteomics with mechanistic studies to assess pathogenic T cell functions and inducing signals. We identified highly activated, CD16 + T cells with increased cytotoxic functions in severe COVID-19. CD16 expression enabled immune complex-mediated, T cell receptor-independent degranulation and cytotoxicity not found in other diseases. CD16 + T cells from COVID-19 patients promoted microvascular endothelial cell injury and release of neutrophil and monocyte chemoattractants. CD16 + T cell clones persisted beyond acute disease maintaining their cytotoxic phenotype. Increased generation of C3a in severe COVID-19 induced activated CD16 + cytotoxic T cells. Proportions of activated CD16 + T cells and plasma levels of complement proteins upstream of C3a were associated with fatal outcome of COVID-19, supporting a pathological role of exacerbated cytotoxicity and complement activation in COVID-19. Generation of the C3a complement protein fragment by SARS-CoV-2 infection drives differentiation of a CD16-expressing T cell population that associates with severe COVID-19 disease outcomes.

                Author and article information

                Contributors
                Journal
                Eur J Microbiol Immunol (Bp)
                Eur J Microbiol Immunol (Bp)
                EUJMI
                European Journal of Microbiology & Immunology
                Akadémiai Kiadó (Budapest )
                2062-509X
                2062-8633
                17 January 2024
                March 2024
                : 14
                : 1
                : 37-43
                Affiliations
                [1 ]Department of Surgical Diseases, University Hospital “Prof. Dr. Stoyan Kirkovich” , Stara Zagora, Bulgaria
                [2 ]Department of Surgical Diseases and Anesthesiology, Faculty of Medicine, Trakia University , Stara Zagora, Bulgaria
                [3 ]Laboratory of Clinical Immunology, University Hospital “Prof. Dr. Stoyan Kirkovich” , Stara Zagora, Bulgaria
                Author notes
                [* ]Corresponding author. Department of Surgical Diseases, University Hospital “Prof. Dr. Stoyan Kirkovich”, Stara Zagora, 2 Gen. Stoletov Str. Bulgaria. Tel.: +359 887 609 943. E-mail: evgeni_d1984@ 123456yahoo.com
                Author information
                https://orcid.org/0000-0001-8888-9702
                Article
                10.1556/1886.2023.00046
                10895360
                38231257
                0c8044ee-889f-4467-a7e9-c7afed47bfd4
                © 2023 The Author(s)

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 22 November 2023
                : 20 December 2023
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 25, Pages: 00
                Categories
                Article

                ncd16,ciais,intra-abdominal infections mortality,prognostic,biomarkers

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