Exploratory Study of CD10low Polymorphonuclear Leukocytes Preceding and Correlating With Postsurgical Inflammation.

Abstract

The lack of diagnostic and monitoring tools for postsurgical immunological complications such as systemic inflammation can contribute to a poor outcome despite modern intensive care. The need for reliable immune monitoring has been emphasised. Polymorphonuclear leukocytes (PMNs) play an important role in postsurgical inflammation. A subgroup of PMNs is particularly interesting, because they are released shortly after (iatrogenic) trauma: immature PMNs, characterised by, for example, their low CD10 expression. Therefore, we investigated the role of CD10^low PMNs in a non-interventional exploratory study by including patients undergoing scheduled, highly standardised cardiac surgery with extracorporeal circulation. We were able to demonstrate that the number of CD10^low PMNs released shortly after the beginning of surgery correlated with different fluid phase markers of inflammation and organ damage postsurgically. Among these parameters were CRP, IL-6, NGAL, CK-MB, and troponin-T. Noteworthy, the amount of CD10^low PMNs increased as early as 24 h before these well-established markers, suggesting superiority of CD10^low PMNs as an early diagnostic marker. Comparing CD10^low immature PMNs with CD10^high mature PMNs revealed potential involved mechanisms, including lower CD11b expression and a significant decrease in the formation of platelet-neutrophil complexes (PNCs) by CD10^low PMNs. In conclusion, we propose CD10^low PMNs as a potential early cellular biomarker to assess the postsurgical inflammatory response. In comparison to clinically established markers like CRP or IL-6 and scoring systems such as the SOFA-Score, CD10^low PMNs reflect a potential candidate for future immune monitoring to determine the risk of excessive inflammation and organ impairment more rapidly.