Inflammatory symptoms and the diagnostic process
By Linda on Oct 1, 2010 in F.I.G.H.T., Infections | comments(0)
Full article: http://www.biomedcentral.com/content/pdf/1471-2334-10-205.pdf
Excerpt:
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.
