Huang CM, Li JJ, Wei WK. Clinical significance of platelet mononuclear cell aggregates in patients with sepsis and acute respiratory distress syndrome. World J Clin Cases 2024; 12(5): 966-972 [PMID: 38414612 DOI: 10.12998/wjcc.v12.i5.966]
Corresponding Author of This Article
Chong-Min Huang, MD, Doctor, Department of Intensive Medicine, The Second People's Hospital of Haining City, No. 85 Guoque Road, Maqiao Street, Haining 314419, Zhejiang Province, China. 15325307291@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 16, 2024; 12(5): 966-972 Published online Feb 16, 2024. doi: 10.12998/wjcc.v12.i5.966
Clinical significance of platelet mononuclear cell aggregates in patients with sepsis and acute respiratory distress syndrome
Chong-Min Huang, Juan-Juan Li, Wei-Ke Wei
Chong-Min Huang, Department of Intensive Medicine, The Second People's Hospital of Haining City, Haining 314419, Zhejiang Province, China
Juan-Juan Li, Wei-Ke Wei, Department of Integrated Traditional Chinese and Western Medicine, Qingyang Hospital, Hangzhou 310023, Zhejiang Province, China
Author contributions: Huang CM performed the study; Li JJ analyzed the data; Wei WK designed the research and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Second People's Hospital of Haining City.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chong-Min Huang, MD, Doctor, Department of Intensive Medicine, The Second People's Hospital of Haining City, No. 85 Guoque Road, Maqiao Street, Haining 314419, Zhejiang Province, China. 15325307291@163.com
Received: November 16, 2023 Peer-review started: November 16, 2023 First decision: December 26, 2023 Revised: December 30, 2023 Accepted: January 24, 2024 Article in press: January 24, 2024 Published online: February 16, 2024 Processing time: 75 Days and 17.6 Hours
Abstract
BACKGROUND
The diagnosis of sepsis combined with acute respiratory distress syndrome (ARDS) has increased owing to the enhanced awareness among medical professionals and the continuous development of modern medical technologies, while early diagnosis of ARDS still lacks specific biomarkers. One of the main pathogenic mechanisms of sepsis-associated ARDS involves the actions of various pathological injuries and inflammatory factors, such as platelet and white blood cells activation, leading to an increase of surface adhesion molecules. These adhesion molecules further form platelet-white blood cell aggregates, including platelet-mononuclear cell aggregates (PMAs). PMAs has been identified as one of the markers of platelet activation, here we hypothesize that PMAs might play a potential biomarker for the early diagnosis of this complication.
AIM
To investigate the expression of PMAs in the serum of patients with sepsis complicated by ARDS and its clinical significance.
METHODS
We selected 72 hospitalized patients diagnosed with sepsis as the study population between March 2019 and March 2022. Among them, 30 patients with sepsis and ARDS formed the study group, while 42 sepsis patients without ARDS comprised the control group. After diagnosis, venous blood samples were immediately collected from all patients. Flow cytometry was employed to analyze the expression of PMAs, platelet neutrophil aggregates (PNAs), and platelet aggregates (PLyAs) in the serum. Additionally, the Acute Physiology and Chronic Health Evaluation (APACHE) II score was calculated for each patient, and receiver operating characteristic curves were generated to assess diagnostic value.
RESULTS
The study found that the levels of PNAs and PLyAs in the serum of the study group were higher than those in the control group, but the difference was not statistically significant (P > 0.05). However, the expression of PMAs in the serum of the study group was significantly upregulated (P < 0.05) and positively correlated with the APACHE II score (r = 0.671, P < 0.05). When using PMAs as a diagnostic indicator, the area under the curve value was 0.957, indicating a high diagnostic value (P < 0.05). Furthermore, the optimal cutoff value was 8.418%, with a diagnostic sensitivity of 0.819 and specificity of 0.947.
CONCLUSION
In summary, the serum levels of PMAs significantly increase in patients with sepsis and ARDS. Therefore, serum PMAs have the potential to become a new biomarker for clinically diagnosing sepsis complicated by ARDS.
Core Tip: Our research aimed to investigate the expression of platelet mononuclear cell aggregates (PMAs) in the serum of patients with sepsis complicated by acute respiratory distress syndrome (ARDS) and its clinical significance. The results indicate that the serum levels of PMAs significantly increase in patients with sepsis and ARDS. Therefore, serum PMAs have the potential to become a new biomarker for clinically diagnosing sepsis complicated by ARDS.
