In canine bacterial pneumonia circulating granulocyte counts determine outcome from donor cells
| Autor: | Willard N, Applefeld, Jeffrey, Wang, Junfeng, Sun, Benjamin M, Pockros, Steven B, Solomon, Jing, Feng, Thomas, Risoleo, Irene, Cortés-Puch, Aurélie, Gouél-Cheron, Harvey G, Klein, Charles, Natanson |
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| Rok vydání: | 2020 |
| Předmět: |
Staphylococcus aureus
medicine.medical_specialty Immunology 030204 cardiovascular system & hematology Lung injury Granulocyte Neutropenia medicine.disease_cause Gastroenterology Leukocyte Count 03 medical and health sciences Dogs 0302 clinical medicine Interquartile range Internal medicine Granulocyte Colony-Stimulating Factor Pneumonia Bacterial medicine Animals Immunology and Allergy Lung business.industry Septic shock Bacterial pneumonia Lung Injury Hematology medicine.disease Tissue Donors Disease Models Animal Leukocyte Transfusion Treatment Outcome medicine.anatomical_structure business Granulocytes 030215 immunology |
| Zdroj: | Transfusion. 60:698-712 |
| ISSN: | 1537-2995 0041-1132 |
| DOI: | 10.1111/trf.15727 |
| Popis: | BACKGROUND In experimental canine septic shock, depressed circulating granulocyte counts were associated with a poor outcome and increasing counts with prophylactic granulocyte colony-stimulating factor (G-CSF) improved outcome. Therapeutic G-CSF, in contrast, did not improve circulating counts or outcome, and therefore investigation was undertaken to determine whether transfusing granulocytes therapeutically would improve outcome. STUDY DESIGN AND METHODS Twenty-eight purpose-bred beagles underwent an intrabronchial Staphylococcus aureus challenge and 4 hours later were randomly assigned to granulocyte (40-100 × 109 cells) or plasma transfusion. RESULTS Granulocyte transfusion significantly expanded the low circulating counts for hours compared to septic controls but was not associated with significant mortality benefit (1/14, 7% vs. 2/14, 14%, respectively; p = 0.29). Septic animals with higher granulocyte count at 4 hours (median [interquartile range] of 3.81 3.39-5.05] vs. 1.77 [1.25-2.50]) had significantly increased survival independent of whether they were transfused with granulocytes. In a subgroup analysis, animals with higher circulating granulocyte counts receiving donor granulocytes had worsened lung injury compared to septic controls. Conversely, donor granulocytes decreased lung injury in septic animals with lower counts. CONCLUSION During bacterial pneumonia, circulating counts predict the outcome of transfusing granulocytes. With low but normal counts, transfusing granulocytes does not improve survival and injures the lung, whereas for animals with very low counts, but not absolute neutropenia, granulocyte transfusion improves lung function. |
| Databáze: | OpenAIRE |
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