Monocyte subset distribution in myeloproliferative and myelodysplastic/myeloproliferative neoplasms with monocytosis

Abstract Background After successful cardiopulmonary resuscitation with return of spontaneous circulation (ROSC), many patients show signs of an overactive immune activation. Monocytes are a heterogenous cell population that can be distinguished into three subsets. Purpose The aim of this prospective, observational study was to analyze whether monocyte subset distribution is associated with mortality at 6 months in patients after cardiac arrest. Methods We included 53 patients admitted to our medical ICU after cardiac arrest. Blood was taken on admission and monocyte subset distribution was analyzed by flow cytometry and distinguished into classical monocytes (CM; CD14++CD16-), intermediate monocytes (IM; CD14++CD16+CCR2+) and non-classical monocytes (NCM; CD14+CD16++CCR2-). Results Median age was 64.5 (IQR 49.8–74.3) years and 75.5% of patients were male. Mortality at 6 months was 50.9% and survival with good neurological outcome was 37.7%. Of interest, monocyte subset distribution upon admission to the ICU did not differ according to survival. However, patients that died within 6 months showed a strong increase in the pro-inflammatory subset of intermediate monocytes (8.3% (3.8–14.6)% vs. 4.1% (1.5–8.2)%; p=0.025), and a decrease of classical monocytes (87.5% (79.9–89.0)% vs. 90.8% (85.9–92.7)%; p=0.036) 72 hours after admission. In addition, intermediate monocytes were predictive of outcome independent of initial rhythm and time to ROSC and correlated with the CPC-score at 6 months (R=0.32; p=0.043). Discussion Monocyte subset distribution is associated with outcome in patients surviving a cardiac arrest. This suggests that activation of the innate immune system may play a significant role in patient outcome after cardiac arrest. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): FWF - Fonds zur Förderung der wissenschaftlichen Forschung

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MONOCYTE SUBSET DISTRIBUTION IS ASSOCIATED WITH OUTCOME IN PATIENTS AFTER CARDIAC ARREST

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(20)30723-3 ◽

2020 ◽

Vol 75 (11) ◽

pp. 96

Author(s):

Konstantin A. Krychtiuk ◽

Max Lenz ◽

Kurt Huber ◽

Christian Hengstenberg ◽

Johann Wojta ◽

...

Keyword(s):

Cardiac Arrest ◽

Monocyte Subset ◽

Subset Distribution

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Case Report: Evolution of a Severe Vascular Refractory Form of ECD Requiring Liver Transplantation Correlated With the Change in the Monocyte Subset Analysis

Frontiers in Immunology ◽

10.3389/fimmu.2021.755846 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jérôme Razanamahery ◽

Anne Roggy ◽

Jean-François Emile ◽

Alexandre Malakhia ◽

Zaher Lakkis ◽

...

Keyword(s):

Liver Transplantation ◽

Disease Activity ◽

White Blood Cells ◽

Monocyte Subset ◽

Pathway Gene ◽

Map Kinase Pathway ◽

Kinase Pathway ◽

Erdheim Chester ◽

Subset Distribution

Erdheim–Chester disease is a rare histiocytosis characterized by iconic features associated with compatible histology. Most patients have somatic mutations in the MAP-kinase pathway gene, and the mutations occur in CD14+ monocytes. Differentiation of the myeloid lineage plays a central role in the pathogenesis of histiocytosis. Monocytes are myeloid-derived white blood cells, divided into three subsets, but only the CD14++CD16− “classical monocyte” can differentiate into dendritic cells and tissue macrophages. Since most mutations occur in CD14+ cells and since ECD patients have a particular monocytic phenotype resembling CMML, we studied the correlation between disease activity and monocytic subset distribution during the course of a severe vascular form of ECD requiring liver transplantation. During early follow-up, increased CD14++CD16− “classical monocyte” associated with decreased CD14lowCD16++ “non-classical monocyte” correlated with disease activity. Further studies are needed to confirm the use of monocyte as a marker of disease activity in patients with ECD.

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Abstract 15905: Monocyte Subsets Predict Mortality After Cardiac Arrest

Circulation ◽

10.1161/circ.142.suppl_3.15905 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Konstantin Krychtiuk ◽

Max Lenz ◽

Bernhard Richter ◽

Philipp Hohensinner ◽

Stefan Kastl ◽

...

Keyword(s):

Cardiac Arrest ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Monocyte Subset ◽

Pronounced Increase ◽

Performance Category ◽

Medical Intensive Care ◽

Classical Monocytes ◽

Intermediate Monocytes ◽

Subset Distribution

Background: After successful cardiopulmonary resuscitation (CPR) with return of spontaneous circulation (ROSC), many patients show signs of an overactive immune activation. Monocytes are a heterogeneous cell population that can be distinguished into three subsets. The aim of this prospective, observational study was to analyse whether monocyte subset distribution is associated with mortality at 6 months in patients after cardiac arrest (CA). Methods: We included 53 patients admitted to our medical intensive care unit (ICU) after CA. Blood was taken on admission and after 72 hours and monocyte subset distribution was analysed by flow cytometry and distinguished into classical monocytes (CD14++CD16-), intermediate monocytes (CD14++CD16+CCR2+) and non-classical monocytes (CD14+CD16++CCR2-). Results: Median age was 64.5 (interquartile range (IQR) 49.8-74.3) years and 75.5% were male. Six-month mortality was 50.9% and survival with good neurological outcome was 37.7%. Monocyte subset distribution upon admission to the ICU did not differ according to survival. However, patients who died within 6 months showed a more pronounced increase in the pro-inflammatory subset of intermediate monocytes (8.3% (3.8-14.6)% vs. 4.1% (1.5-8.2)%; p=0.025), and a decrease of classical monocytes (87.5% (79.9-89.0)% vs. 90.8% (85.9-92.7)%; p=0.036) 72 hours after admission. In addition, intermediate monocytes were predictive of outcome independent of time to ROSC and witnessed cardiac arrest, and correlated with the cerebral performance category (CPC)-score at 6 months (R=0.32; p=0.043). Discussion: Monocyte subset distribution is associated with outcome in patients surviving a CA. The activation of the innate immune system may play a significant role in CA patients.

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Intermediate density lipoprotein is associated with monocyte subset distribution in patients with stable atherosclerosis

Atherosclerosis ◽

10.1016/j.atherosclerosis.2016.07.826 ◽

2016 ◽

Vol 252 ◽

pp. e176

Author(s):

K. Krychtiuk ◽

S. Kastl ◽

T. Pongratz ◽

G. Goliasch ◽

L. Gaspar ◽

...

Keyword(s):

Density Lipoprotein ◽

Monocyte Subset ◽

Intermediate Density Lipoprotein ◽

Intermediate Density ◽

Subset Distribution

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Monocyte subset distribution in patients with stable atherosclerosis and elevated levels of lipoprotein(a)

Journal of Clinical Lipidology ◽

10.1016/j.jacl.2015.04.005 ◽

2015 ◽

Vol 9 (4) ◽

pp. 533-541 ◽

Cited By ~ 20

Author(s):

Konstantin A. Krychtiuk ◽

Stefan P. Kastl ◽

Sebastian L. Hofbauer ◽

Anna Wonnerth ◽

Georg Goliasch ◽

...

Keyword(s):

Monocyte Subset ◽

Lipoprotein A ◽

Subset Distribution

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Monocyte subset distribution is associated with mortality in critically ill patients

Thrombosis and Haemostasis ◽

10.1160/th16-05-0405 ◽

2016 ◽

Vol 116 (11) ◽

pp. 949-957 ◽

Cited By ~ 11

Author(s):

Konstantin A. Krychtiuk ◽

Max Lenz ◽

Lorenz Koller ◽

Maria C. Honeder ◽

Lisa Wutzlhofer ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Tertiary Care ◽

Primary Diagnosis ◽

Apache Ii ◽

Apache Ii Score ◽

Monocyte Subset ◽

Tertiary Care Centre ◽

Classical Monocytes ◽

Subset Distribution

SummaryAlthough patients admitted to an intensive care unit (ICU) suffer from various pathologies, many develop a systemic inflammatory response syndrome (SIRS). As key regulators of innate immunity, monocytes may be crucially involved in SIRS development. Monocytes can be distinguished into three subsets: Classical monocytes (CD14++CD16−; CM), non-classical monocytes (CD14+CD16++CCR2−; NCM) and intermediate monocytes (CD14++CD16+CCR2+; IM). The aim of this prospective, observational study was to analyse whether monocyte subset distribution is associated with 30-day survival in critically ill patients. A total of 195 consecutive patients admitted to a cardiac ICU at a tertiary-care centre were enrolled, blood was taken at admission and after 72 hours and monocyte subset distribution was analysed. Mean APACHE II score was 19.5 ± 8.1 and 30-day mortality was 25.4 %. At admission, NCM were significantly lower in non-survivors as compared to survivors [2.7 (0.4–5.5) vs 4.2 (1.6–7.5)%; p=0.012] whereas CM and IM did not differ according to 30-day survival. In contrast, 72 hours after admission, monocyte subset distribution shifted towards an increased proportion of IM [8.2 (3.9–13.2) vs 4.2 (2.3–7.9)%; p=0.003] with a concomitant decrease of CM [86.9 (78.6–89.2) vs 89.6 (84.9–93.1)%; p=0.02] in non-survivors vs survivors, respectively. NCM at day 3 were not associated with death at 30 days. These results were independent from age, gender, CRP, APACHE II score and primary diagnosis. In conclusion, circulating monocyte subsets are associated with 30-day mortality in critically ill patients. The innate immune system as reflected by monocyte subset distribution may play a major role in ICU outcome despite varying admittance pathologies.Supplementary Material to this article is available online at www.thrombosis-online.com.

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