Reply: Neutrophil CD64 Expression Is Elevated in Acetaminophen-induced Acute Liver Failure (original) (raw)

2012, American Journal of Respiratory and Critical Care Medicine

Whole ethylenediaminetetraacetic acid blood was analyzed by flow cytometry using antibodies against CD16 and CD64 (6). Results are expressed as mean fluorescence intensity (MFI) and interquartile range. Neutrophil CD64 expression in A-ALF (CD64 MFI 398 [208-568]) was lower than in sepsis (707 [425-1,956]) (P , 0.05) but higher than healthy controls (195 [182-285]) (P , 0.001; Figure 1). AUROC analysis of neutrophil CD64 expression to discriminate between A-ALF and sepsis gave a value of 0.784 (95% confidence interval, 0.619-0.948; P , 0.01). A cutoff of 547 gave a sensitivity of 71%, specificity of 72%, positive predictive value 72%, and negative predictive value 71%. Patients with A-ALF who died or required emergency liver transplantation tended to have higher neutrophil CD64 (568 [400-654]) compared with those who survived with medical management alone (371 [307-493]) (P ¼ 0.07). In conclusion, neutrophil CD64 is elevated in severe sterile inflammatory states such as A-ALF, possibly due to stimulation of TLR4 pathways by endogenous damage-associated molecular pattern molecules (e.g., HMGB1). This may reduce neutrophil CD64's ability to discriminate infection in critically ill patients with high levels of organ dysfunction.

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Reply: Neutrophil CD64 Expression Is Elevated in Acetaminophen-induced Acute Liver Failure (original) (raw)

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