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Keywords = Granulocytes, Immature

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12 pages, 805 KB  
Article
Immature Granulocyte Trajectories Following Hemadsorption as Indicators of Immune Dysregulation and Mortality
by Gülsüm Altuntaş, Ayşe Çapar, Gülsüm Özçelik, Erkan Çakmak, Lütfiye Kadioğlu Dalkiliç and İsmail Demirel
J. Clin. Med. 2026, 15(3), 1011; https://doi.org/10.3390/jcm15031011 - 27 Jan 2026
Abstract
Background: Sepsis is a life-threatening condition characterized by a dysregulated host response to infection. Hemadsorption therapies remove inflammatory mediators and are used as adjunctive treatment in selected patients. Although increased immature granulocyte (IG) levels correlate with inflammatory severity, changes in IG levels after [...] Read more.
Background: Sepsis is a life-threatening condition characterized by a dysregulated host response to infection. Hemadsorption therapies remove inflammatory mediators and are used as adjunctive treatment in selected patients. Although increased immature granulocyte (IG) levels correlate with inflammatory severity, changes in IG levels after hemadsorption therapy have not been previously evaluated. Methods: This retrospective observational study included patients with sepsis who received hemadsorption therapy in intensive care units between January 2021 and July 2025. Sepsis was diagnosed according to the Surviving Sepsis Campaign 2021 guidelines, and hemadsorption was initiated for persistent hemodynamic instability despite standard therapy. Treatment was performed using a Jafron HA330 cartridge for at least three 6 h sessions. IG count and percentage, inflammatory parameters, lactate levels, and organ dysfunction scores were recorded before and after therapy. ICU mortality was the primary outcome. Statistical analyses included paired comparisons, multivariable logistic regression, and ROC curve analysis. Results: Among 887 patients with sepsis, 196 met the inclusion criteria. The ICU mortality rate was 43.9%, and the median time between pre- and post-treatment measurements was 4 days (IQR: 3–5). After hemadsorption therapy, IG count, IG%, inflammatory parameters, lactate levels, SOFA scores, and vasopressor requirements decreased (all p-values < 0.001). IG parameters were higher in non-survivors. Post-treatment IG# (AUC 0.880) and IG% (AUC 0.812) showed good discriminative performance. Conclusions: Hemadsorption therapy was associated with reductions in IG parameters and inflammatory indicators in sepsis. These findings support IG parameters as complementary measures of immune and inflammatory dynamics during hemadsorption therapy. Accordingly, this study should be regarded as a hypothesis-generating investigation describing associations of IG dynamics in septic patients undergoing hemadsorption, rather than demonstrating treatment efficacy or causal effects. Full article
(This article belongs to the Section Hematology)
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11 pages, 1391 KB  
Article
Delta Neutrophil Index in Suspected Septic Arthritis: A Diagnostic Accuracy Study
by Hüseyin Emre Tepedelenlioğlu, Hilmi Alkan, Tural Talıblı, Ünal Erkanov Hüseyinov, Ferid Abdulaliyev, Erkan Akgün and Vedat Biçici
J. Clin. Med. 2026, 15(2), 840; https://doi.org/10.3390/jcm15020840 - 20 Jan 2026
Viewed by 109
Abstract
Background/Objectives: Septic arthritis of native joints is an orthopedic emergency in which rapid discrimination from non-infectious arthritis is crucial. Because cartilage damage can occur within hours, urgent irrigation and debridement are often pursued on an emergency basis (ideally within the first 6–8 h) [...] Read more.
Background/Objectives: Septic arthritis of native joints is an orthopedic emergency in which rapid discrimination from non-infectious arthritis is crucial. Because cartilage damage can occur within hours, urgent irrigation and debridement are often pursued on an emergency basis (ideally within the first 6–8 h) of presentation, underscoring the need for rapidly available biomarkers. The delta neutrophil index (DNI) quantifies circulating immature granulocytes and may complement conventional inflammatory biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC), and procalcitonin (PCT). We evaluated the diagnostic performance of DNI for native-joint septic arthritis against both microbiologic and clinical reference standards. Methods: We retrospectively analyzed 85 adults who underwent surgical irrigation and debridement for suspected native joint septic arthritis at a tertiary center. Serum CRP, ESR, WBC, DNI, and PCT (available in 67 patients) were recorded together with synovial leukocyte counts. Infection status was defined using either positive synovial culture (microbiologic reference) or clinical adjudication according to the Guideline for management of septic arthritis in native joints (SANJO). Diagnostic performance was assessed using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC); exploratory cut-offs were identified by the Youden index, and pairwise AUCs were compared using DeLong’s test. Results: Synovial leukocyte analysis was highly sensitive but poorly specific (sensitivity 92.9%, specificity 10.3%). Against culture, DNI showed the highest discrimination (AUC = 0.914), exceeding CRP (0.687), ESR (0.643), WBC (0.648), and PCT (0.697); DeLong ΔAUC vs. CRP 0.227 (p < 0.001), ESR 0.270 (p < 0.001), WBC 0.266 (p < 0.001), PCT 0.227 (p = 0.001). At pre-specified cut-offs, DNI showed the most balanced sensitivity/specificity (94.3%/84.0%), corresponding to a negative predictive value (NPV) of 95.5% (42/44) and a positive predictive value (PPV) of 80.5% (33/41) against culture in this cohort. Against clinical infection, DNI outperformed others (AUC:0.921; ΔAUC vs. CRP = 0.204, ESR = 0.343, WBC = 0.244, PCT = 0.295; all p < 0.001). As a rule-in threshold, DNI ≥ 0.6 yielded a specificity of 100% with a sensitivity of 73.2%. In culture-negative patients (infected n = 21, uninfected n = 29), DNI remained discriminatory (AUC 0.80, p < 0.001), whereas other biomarkers were not. Conclusions: DNI demonstrated superior diagnostic accuracy compared with conventional inflammatory biomarkers. As a rapid parameter available with the initial complete blood count, DNI may support early risk stratification and rule-in decisions within the first hours of presentation; however, it should be used as a supplementary indicator alongside synovial fluid analysis and clinical assessment rather than as a stand-alone diagnostic tool. Full article
(This article belongs to the Special Issue Clinical Advances in Orthopedic Infections)
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14 pages, 628 KB  
Article
Evaluating the Effects of Full-Fat Yogurt Consumption on Circulating Inflammatory Biomarkers and Ex Vivo Peripheral Blood Mononuclear Cell Inflammatory Responses in a Randomized-Controlled Crossover Trial
by Victoria M. Taormina, Simonne Eisenhardt, Matthew P. Gilbert, C. Lawrence Kien, Matthew E. Poynter and Jana Kraft
Lipidology 2026, 3(1), 4; https://doi.org/10.3390/lipidology3010004 - 15 Jan 2026
Viewed by 134
Abstract
Chronic, low-grade inflammation is a characteristic of metabolic diseases like type 2 diabetes. Despite recommendations to select low- or non-fat dairy foods over full-fat dairy foods for metabolic health, recent research suggests potential anti-inflammatory benefits of dairy fat consumption. We aimed to compare [...] Read more.
Chronic, low-grade inflammation is a characteristic of metabolic diseases like type 2 diabetes. Despite recommendations to select low- or non-fat dairy foods over full-fat dairy foods for metabolic health, recent research suggests potential anti-inflammatory benefits of dairy fat consumption. We aimed to compare the systemic inflammatory tone (i.e., circulating inflammatory biomarker concentrations and ex vivo peripheral blood mononuclear cell inflammatory responses) of individuals with prediabetes after consuming diets with full-fat (3.25%) or non-fat yogurt. We hypothesized that short-term consumption of three daily full-fat yogurt servings beneficially affects inflammatory tone. Thirteen participants aged 45–75 years completed an eight-week randomized, double-masked, controlled crossover study. The two, three-week experimental diets comprised three daily servings of full-fat or non-fat yogurt and were each preceded by a one-week run-in diet. Following each diet, circulating inflammatory biomarkers and cytokine concentrations in the supernatants of peripheral blood mononuclear cells under control or lipopolysaccharide-stimulated conditions were measured. Compared with non-fat yogurt intake, circulating immature granulocyte concentrations were lower following full-fat yogurt intake, but there were no other differences in leukocyte concentrations. Circulating concentrations of cytokines or other inflammatory markers did not differ by diet. Cell supernatant interleukin-1β concentrations were lower following the full-fat yogurt diet under unstimulated conditions but were not different between diets under stimulated conditions. There were no differences by diet in supernatant concentrations of other cytokines under unstimulated or stimulated conditions. Together, minimal differences in inflammatory tone were observed following the short-term consumption of three daily servings of full-fat or non-fat yogurt in individuals with prediabetes. Full article
(This article belongs to the Special Issue Lipid Metabolism and Inflammation-Related Diseases)
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12 pages, 805 KB  
Article
The Accuracy and Sensitivity of Delta Neutrophil Index in Malignancy: Diagnostic Study of Different Types
by Hüseyin Emre Tepedelenlioğlu, Hüseyin Bilgehan Çevik, Özgen Ahmet Yildirim, Ahmet Kürşat Güneş, Erkan Akgün and Hanife Avcı
Diagnostics 2025, 15(24), 3187; https://doi.org/10.3390/diagnostics15243187 - 13 Dec 2025
Viewed by 322
Abstract
Background/Objectives: The delta neutrophil index (DNI)—a hematology analyzer-derived measure of circulating immature granulocytes—may assist pre-biopsy decision-making, yet its behavior across tumor types is incompletely defined. We examined whether pre-biopsy DNI differs by pathology category, tumor class, and definitive histology, and evaluated diagnostic performance. [...] Read more.
Background/Objectives: The delta neutrophil index (DNI)—a hematology analyzer-derived measure of circulating immature granulocytes—may assist pre-biopsy decision-making, yet its behavior across tumor types is incompletely defined. We examined whether pre-biopsy DNI differs by pathology category, tumor class, and definitive histology, and evaluated diagnostic performance. Methods: In this retrospective, single-center cohort, consecutive inpatients with malignancy were screened (n = 2009). Exclusions included positive blood cultures, prior chemotherapy/radiotherapy before index labs, and lack of definitive pathology, yielding 1313 analyzable cases. All laboratories, including DNI, were obtained before diagnostic biopsy. DNI was assessed as a continuous variable and categorized (Zero = 0; High > 0.6). Groupwise differences used Kruskal–Wallis and χ2 tests with FDR control; discrimination used ROC analyses (one-versus-rest/pairwise). Results: DNI distributions differed across pathology, tumor class, and definitive diagnoses (all p < 0.001). High DNI (>0.6) and Zero DNI (=0) proportions also varied significantly by grouping. Hematologic malignancies showed the highest DNI (median ~1.0) compared with sarcoma and carcinoma (medians ~0.4). Using DNI alone, one-versus-rest AUCs were 0.735 (hematologic), 0.692 (melanoma), 0.672 (sarcoma), and 0.652 (carcinoma); the strongest pairwise separation was hematologic versus sarcoma (AUC 0.780). For specific solid tumors, including breast and renal cell carcinoma, single-marker discrimination was modest; no clinically actionable RCC cutoff emerged. Sensitivity analyses restricted to culture-negative cases yielded consistent findings. Conclusions: Pre-biopsy DNI exhibits tumor-type-dependent variation and provides adjunct diagnostic signal—the strongest for hematologic malignancy—yet is insufficient alone for solid tumor subtyping. Integration with clinical assessment and routine biomarkers, and multi-center validation with device harmonization are warranted. Full article
(This article belongs to the Special Issue Current Diagnosis and Treatment in Surgical Oncology)
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14 pages, 528 KB  
Article
The Role of Immature Granulocyte Percentage and Other Inflammatory Hematological Markers in Predicting In Vitro Fertilization Success
by Dilay Gök Korucu, Emre Uysal, Fatih Akkuş, Pınar Tombaklar, Şükran Doğru and Oğuzhan Günenç
Biomedicines 2025, 13(11), 2819; https://doi.org/10.3390/biomedicines13112819 - 19 Nov 2025
Viewed by 656
Abstract
Background: This study explores the role of inflammatory hematological markers from complete blood count (CBC) parameters in predicting the in vitro fertilization (IVF) treatment success of patients. It focuses particularly on the immature granulocyte (IG) percentage, a novel inflammatory marker. To our knowledge, [...] Read more.
Background: This study explores the role of inflammatory hematological markers from complete blood count (CBC) parameters in predicting the in vitro fertilization (IVF) treatment success of patients. It focuses particularly on the immature granulocyte (IG) percentage, a novel inflammatory marker. To our knowledge, this is the first study in the literature examining the relationship between IG percentage and pregnancy outcomes in IVF. Methods: Conducted retrospectively, this study included 311 IVF cycles from 311 distinct patients. A binomial logistic regression model identified factors affecting pregnancy outcomes. Various predictors were analyzed, including embryo quality, white blood cell (WBC) count, IG percentage, systemic inflammatory index (SII), endometrial thickness on the day of human chorionic gonadotropin (hCG) administration, number of mature (MII) oocytes, and the number of embryos generated. Results: The IG percentage significantly impacted clinical pregnancy and live birth outcomes (OR = 0.40, 95% CI (confidence interval): 0.317–0.51, p < 0.001), unlike other inflammatory markers. Each millimeter increase in endometrial thickness measured on the day of hCG administration was associated with a slight increase in the likelihood of IVF success (OR: 1.20, 95% CI 1.004–1.44, p = 0.044). Neither SII nor mature oocyte count significantly affected pregnancy outcomes. Conclusions: A low IG percentage correlates positively with clinical pregnancy and live birth outcomes. Measuring IG percentage offers a rapid, inexpensive, and readily available method to predict IVF success. Full article
(This article belongs to the Special Issue New Advances in Human Reproductive Biology)
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10 pages, 402 KB  
Article
The Role of Immature Granulocytes in Fibromyalgia: An Indicator of Subclinical Inflammation?
by Mehmet Serhat Topaloğlu, Medeni Arpa, Bayram Şen, Hacer Bilgin Topaloğlu and Osman Cüre
Biomedicines 2025, 13(10), 2511; https://doi.org/10.3390/biomedicines13102511 - 15 Oct 2025
Viewed by 990
Abstract
Background: Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread body pain and various symptoms. Its etiology remains unclear to date. It has been associated with various pathogenic mechanisms, primarily inflammation. Immature granulocytes (IGs) have been proposed as a potential biomarker, playing [...] Read more.
Background: Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread body pain and various symptoms. Its etiology remains unclear to date. It has been associated with various pathogenic mechanisms, primarily inflammation. Immature granulocytes (IGs) have been proposed as a potential biomarker, playing a role in both inflammatory responses and prognosis in numerous diseases. No other study has investigated the count of immature granulocytes (IG#) and percentage of immature granulocytes (IG%) in FM patients. The aim of this study is to investigate the IG# and IG% in FM patients and to evaluate the relationship between these parameters and disease parameters. Methods: This retrospective observational study included 95 patients diagnosed with FM and 63 healthy control subjects matched for body mass index and gender. Biochemical, hematological parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and other inflammatory markers were recorded for both groups. Fibromyalgia Survey Diagnostic Criteria and Severity Scale (FSDC) and Fibromyalgia Impact Questionnaire (FIQ) scores were recorded for FM patients. Results: In FM patients, the IG% and IG# were significantly higher than in the healthy control group (p < 0.001, p: 0.006, respectively). There was no significant difference between the CRP and ESR values of the two groups. The platelet large cell count (PLCC) was significantly lower in the FM group (p < 0.032). Conclusions: IG levels can be used as a systemic early, sensitive, and low-cost marker in patients with FM. Based on our current knowledge, and considering the heterogeneous nature of FM, IG levels may serve as a meaningful tool in identifying subgroup elements reflecting an inflammatory phenotype. However, these findings require further validation through larger sample size, prospective studies, and advanced analyses including cytokine levels. Full article
(This article belongs to the Section Molecular and Translational Medicine)
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15 pages, 644 KB  
Article
Evaluation of Platelet Indices and Reticulated Platelets Using the ADVIA 2120 Analyzer in Patients with Acute Infection or Acute Coronary Syndrome, at Onset
by Vincenzo Brescia, Antonella Mileti, Roberto Lovero, Lucia Varraso, Francesco Pignataro, Francesca Di Serio, Angela Pia Cazzolla, Luigi Santacroce, Maria Eleonora Bizzoca, Vito Crincoli and Maria Severa Di Comite
Med. Sci. 2025, 13(4), 232; https://doi.org/10.3390/medsci13040232 - 14 Oct 2025
Viewed by 933
Abstract
Background: The aim of this study was to evaluate the changes in platelet indices (PLT) provided by the ADVIA 2120 hematology analyzer (Siemens Hematology System) in the early stages of onset of infections and acute coronary syndromes (ACSs). Methods: Samples were selected from [...] Read more.
Background: The aim of this study was to evaluate the changes in platelet indices (PLT) provided by the ADVIA 2120 hematology analyzer (Siemens Hematology System) in the early stages of onset of infections and acute coronary syndromes (ACSs). Methods: Samples were selected from 40 patients admitted to the intensive care unit with suspected uncomplicated sepsis at presentation, from 40 patients with a biochemical diagnosis of ACS at presentation and from 40 apparently healthy subjects. These samples were tested for PLT and PLT indices [mean platelet volume (MPV); mean platelet mass (MPM); mean platelet component (MPC); immature platelets (RtcPlts)] obtained by automation with the ADVIA 2120 and specific biomarkers for sepsis [white blood cells (WBCs); neutrophil granulocytes (NGs); presepsin (PSP); procalcitonin (Pct); C-reactive protein (CRP)] and for SCA (hs cTnI). Results: Platelet indices (RtcPlts, MPV, MPM) were significantly altered (p > 0.005) in patients with suspected sepsis and patients with ACS compared to control subjects; however, no statistically significant difference was observed between the two groups of patients with disease. Cutoff values (ROC curves) were obtained for platelet indices that best discriminated healthy subjects from subjects with severe infection or ACS. Conclusions: Our data show that, in subjects with suspected sepsis and ACS at disease onset, a state of early platelet activation exists that is not disease-specific. Immature platelets (RtcPlts) and the platelet indices MPM and MPV, provided by the ADVIA 2120 hematology analyzer, showed high sensitivity in subjects with suspected sepsis or ACS at disease onset. Full article
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13 pages, 1005 KB  
Article
Association of Gla-Rich Protein (GRP) with Inflammatory Markers in Critically Ill Patients: A Cross-Sectional Observational Study
by Elif Eygi, Sinem Bayrakçı, Onur Bayrakçı, Nazire Ates Ayhan, Ahmet Atlas, Metin Kilinc and Recep Dokuyucu
Metabolites 2025, 15(9), 611; https://doi.org/10.3390/metabo15090611 - 13 Sep 2025
Cited by 1 | Viewed by 758
Abstract
Objectives: Gla-rich protein (GRP), a vitamin K-dependent protein, has been increasingly recognized for its dual role in modulating inflammation and inhibiting pathological calcification. Despite its emerging importance in chronic conditions, limited evidence exists regarding its behavior during acute critical illness. This study aimed [...] Read more.
Objectives: Gla-rich protein (GRP), a vitamin K-dependent protein, has been increasingly recognized for its dual role in modulating inflammation and inhibiting pathological calcification. Despite its emerging importance in chronic conditions, limited evidence exists regarding its behavior during acute critical illness. This study aimed to investigate the association between GRP, systemic inflammatory markers, oxidative stress (via total thiol oxidation-reduction ratio, TORR), and calcium metabolism in critically ill patients. Materials and Methods: This cross-sectional observational study included 93 critically ill patients admitted to the intensive care unit (ICU) and 60 age- and sex-matched non-critically ill volunteers. Serum GRP levels were measured using ELISA. Other biomarkers including TORR, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), immature granulocytes (IGs), and serum calcium were also analyzed. Pearson’s correlation, multivariate linear regression, and ROC analysis were performed to assess the relationships among GRP and biochemical markers, as well as their capacity to differentiate ICU patients from controls. Results: GRP, TORR, CRP, PCT, WBC, IGs, and ferritin levels were significantly elevated in ICU patients compared to the control group, whereas serum calcium levels were markedly reduced (all p < 0.05). GRP levels demonstrated moderate positive correlations with WBC (r = 0.47), neutrophils (r = 0.51), TORR (r = 0.42), CRP (r = 0.30), and IGs (r = 0.46), and a strong negative correlation with calcium (r = −0.63). In multivariate regression, TORR, CRP, WBC, IGs, PCT, and calcium levels showed significant correlations with GRP levels in univariate analysis. ROC analysis revealed that CRP had the highest discriminatory power (AUC = 0.88; 95% CI: 0.82–0.94), followed by TORR (AUC = 0.79; 95% CI: 0.71–0.86), GRP (AUC = 0.76; 95% CI: 0.68–0.84), and IGs (AUC = 0.77; 95% CI: 0.69–0.85), for distinguishing ICU patients from non-critically ill individuals. Conclusions: Our findings demonstrated that GRP is significantly associated with systemic inflammation, oxidative stress, and calcium metabolism disturbances in critically ill patients. The combined evaluation of GRP and TORR may enhance the understanding of inflammatory and oxidative mechanisms in acute critical illness. Although this study did not assess patient outcomes, these biomarkers could serve as promising candidates for future prognostic research in ICU settings. Full article
(This article belongs to the Special Issue Metabolite Profiles in Inflammatory Diseases)
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17 pages, 2593 KB  
Article
Immunophenotypic Profile of Normal Hematopoietic Populations in Human Bone Marrow: Influence of Gender and Aging as a Basis for Reference Value Establishment
by Flavia Arandas de Sousa, Rodolfo Patussi Correa, Laiz Cameirão Bento, Luiz Fabiano Presente Taniguchi, Nydia Strachman Bacal and Luciana Cavalheiro Marti
Cells 2025, 14(17), 1392; https://doi.org/10.3390/cells14171392 - 6 Sep 2025
Viewed by 1415
Abstract
The purpose of this study was to evaluate normal values of healthy human bone marrow (n = 56) and identify gender- and age-related variations using cell lineage markers and maturational curves. Using 10-color quantitative flow cytometry, various cell types were identified, including [...] Read more.
The purpose of this study was to evaluate normal values of healthy human bone marrow (n = 56) and identify gender- and age-related variations using cell lineage markers and maturational curves. Using 10-color quantitative flow cytometry, various cell types were identified, including B cells, T cells, NK cells, granulocytes, monocytes, erythroblasts, plasma cells, basophils, mast cells, and dendritic cells. Results revealed significant age-related declines in the absolute counts of nucleated cells (p = 0.001), including CD34+ immature B cells (p = 0.006) and CD34- immature B cells (p = 0.004). Declines were also observed for T cells (p = 0.002), cytotoxic T cells (p < 0.001), double-negative T cells (p = 0.0001), NK cells (p = 0.007), CD16- NK cells (p < 0.001), metamyelocytes (p = 0.002), neutrophils (p = 0.001), basophils (p = 0.009), promonocytes (p = 0.001), mature monocytes (p = 0.007), and plasmacytoid dendritic cells (p = 0.001). Gender differences showed males had more intermediate monocytes (p = 0.009) compared to females. In summary, this study provides normal values for hematopoietic cells, highlighting age- and gender-related disparities critical for understanding hematopoietic dynamics. Full article
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32 pages, 7204 KB  
Article
The Diagnostic Performance of the Cellavision DC-1 Digital Morphology Analyser on Leukaemia Samples
by Annabel Kowald, Chun Ho Fung, Jane Moon and Sapha Shibeeb
Diagnostics 2025, 15(16), 2029; https://doi.org/10.3390/diagnostics15162029 - 13 Aug 2025
Viewed by 1919
Abstract
Background/Objectives: Digital morphology analysers have been developed to overcome the limitations of manual microscopy. This study aimed to evaluate the performance of the DC-1 on leukaemia samples, determining if it is a suitable for the identification of leukaemia in low-throughput or remote laboratories. [...] Read more.
Background/Objectives: Digital morphology analysers have been developed to overcome the limitations of manual microscopy. This study aimed to evaluate the performance of the DC-1 on leukaemia samples, determining if it is a suitable for the identification of leukaemia in low-throughput or remote laboratories. To the best of our knowledge, there is no current published literature evaluating the performance of the DC-1 with leukaemia samples. Methods: This study utilised 88 leukaemia peripheral blood smears donated from various anonymous hospitals and medical laboratories in collaboration with RMIT university. DC-1 pre-classification was compared with post-classification using Cohen’s kappa, sensitivity, and specificity calculations. Pre- and post-classification was compared with manual microscopy using Passing–Bablok regression, Pearson’s r correlation, and Bland–Altman analysis. Results: DC-1 pre-classification results showed a moderate agreement with post-classification (k = 0.52), a very high specificity for most leukocytes (>94%) and variable sensitivity (21–86%). Pre- and post-classification displayed a higher accuracy and correlation with manual results for segmented neutrophils and lymphocytes, compared to other leukocyte classes. Additionally, there was an improvement in the post-classification of immature granulocytes, band neutrophils, and blast cells compared to pre-classification. Conclusions: The results indicate that the DC-1 displayed a better performance for the classification of segmented neutrophils and lymphocytes compared to other cell classes, indicating that the DC-1 is more acceptable for use in infection or normal samples, as opposed to leukaemia. The gold standard therefore remains with the morphologist who can distinguish leukaemia samples. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Hematological Disease)
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17 pages, 3305 KB  
Article
Evolution of Blood Innate Immune Cell Phenotypes Following SARS-CoV-2 Infection in Hospitalized Patients with COVID-19
by Arnaud Dendooven, Stephane Esnault, Marie Jacob, Jacques Trauet, Emeline Delaunay, Thomas Guerrier, Amali E. Samarasinghe, Floriane Mirgot, Fanny Vuotto, Karine Faure, Julien Poissy, Marc Lambert, Myriam Labalette, Guillaume Lefèvre and Julie Demaret
Cells 2025, 14(14), 1093; https://doi.org/10.3390/cells14141093 - 17 Jul 2025
Cited by 1 | Viewed by 1465
Abstract
Innate immune cells appear to have an important implication in the resolution and/or the aggravation of the COVID-19 pathogenesis after infection with SARS-CoV-2. To better appreciate the role of these cells during COVID-19, changes in blood eosinophil, the neutrophil and monocyte count, and [...] Read more.
Innate immune cells appear to have an important implication in the resolution and/or the aggravation of the COVID-19 pathogenesis after infection with SARS-CoV-2. To better appreciate the role of these cells during COVID-19, changes in blood eosinophil, the neutrophil and monocyte count, and levels of surface protein markers have been reported. However, analyses at several timepoints of multiple surface markers on granulocytes and monocytes over a period of one month after a SARS-CoV-2 infection are missing. Therefore, in this study, we performed blood eosinophil, neutrophil, and monocyte phenotyping using a list of surface proteins and flow cytometry during a period of 30 days after the hospitalization of patients with severe SARS-CoV-2 infections. Blood cell counts were reported at seven different timepoints over the 30-day period as well as measures of multiple mediators in serum using a targeted multiplex assay approach. Our results indicate a 95% drop in the blood eosinophil count by D1, with eosinophils displaying a phenotype defined as CD69/CD63/CD125high and CCR3/CD44low during the early phases of hospitalization. Conversely, by D7 the neutrophil count increased significantly and displayed an immature, activated, and immunosuppressive phenotype (i.e., 3% of CD10/CD16low and CD10lowCD177high, 6.7% of CD11bhighCD62Llow, and 1.6% of CD16highCD62Llow), corroborated by enhanced serum proteins that are markers of neutrophil activation. Finally, our results suggest a rapid recruitment of non-classical monocytes leaving CD163/CD64high and CD32low monocytes in circulation during the very early phase. In conclusion, our study reveals potential very early roles for eosinophils and monocytes in the pathogenesis of COVID-19 with a likely reprogramming of eosinophils in the bone marrow. The exact roles of the pro-inflammatory neutrophils and the functions of the eosinophils and the monocytes, as well as these innate immune cell types, interplays need to be further investigated. Full article
(This article belongs to the Special Issue Eosinophils and Their Role in Allergy and Related Diseases)
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12 pages, 588 KB  
Article
A Usefulness of Delta Neutrophil Index (DNI) for Prediction of 28 Day Mortality in Patients with Pneumonia-Induced Sepsis in the Intensive Care Unit
by SooYoon Moon, YongBum Park, Chang-Won Hong, Sunghoon Park, YunSu Sim, Yousang Ko and SoYoung Park
J. Clin. Med. 2025, 14(6), 2002; https://doi.org/10.3390/jcm14062002 - 15 Mar 2025
Cited by 1 | Viewed by 1407
Abstract
Background: The delta neutrophil index (DNI) represents the immature granulocyte fraction and is determined by subtracting the fraction of mature polymorphonuclear leucocytes from the sum of myeloperoxidase-reactive cells. The DNI has been proposed as a useful prognostic marker for sepsis. This study [...] Read more.
Background: The delta neutrophil index (DNI) represents the immature granulocyte fraction and is determined by subtracting the fraction of mature polymorphonuclear leucocytes from the sum of myeloperoxidase-reactive cells. The DNI has been proposed as a useful prognostic marker for sepsis. This study evaluated the clinical utility of DNI as a predictive marker in patients with pneumonia-induced sepsis in the intensive care unit (ICU). Methods: We conducted a retrospective study of pneumonia-induced sepsis in patients who were admitted to the Kangdong Sacred Heart Hospital’s medical ICUs from July 2022 to March 2024. The DNI was measured on three consecutive days after ICU admission. The primary outcome of this study was a 28-day mortality. Results: A total of 227 patients with pneumonia-induced sepsis were included in this study. A 28-day mortality occurred 20.3% of the time in our study. In a univariate analysis, age (p = 0.05), lymphocyte (p = 0.02), DNI 1 (p = 0.01), DNI 2 (p = 0.00), DNI 3 (p = 0.00), and lactic acid (p = 0.00) were significantly associated with 28-day mortality. In a multivariable analysis, lactate (adj. OR: 0.86, 95% CI: 0.78–0.95, p = 0.002), and DNI 3 (adj. OR: 0.94, 95% CI: 0.89–0.99, p = 0.048) were significantly associated with 28-day mortality. In our study, the most appropriate cut-off values were DNI 1 (7.15), DNI 2 (8.9), and DNI 3 (2.6). Patients with higher DNI 3 (≥2.6) showed higher 28-day mortality than patients with lower DNI 3 values of <2.6 (67.4% vs. 32.6%; p < 0.001). However, those aged ≥70 did not show statistically significantly different DNI 1 values between the survivor and non- survivor groups. Conclusions: The DNI at 72 h after ICU admission is a promising predictive prognostic marker of 28-day mortality in patients with pneumonia-induced sepsis in the ICU. However, the interpretation of the DNI in sepsis patients aged 70 and older on the first day of hospitalization should be approached with caution. Full article
(This article belongs to the Section Intensive Care)
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9 pages, 388 KB  
Article
Comparison of Oxidative Stress Markers with Clinical Data in Patients Requiring Anesthesia in an Intensive Care Unit
by Fatih Segmen, Semih Aydemir, Onur Küçük, Cihangir Doğu and Recep Dokuyucu
J. Clin. Med. 2024, 13(22), 6979; https://doi.org/10.3390/jcm13226979 - 20 Nov 2024
Cited by 5 | Viewed by 1680
Abstract
Objectives: The aim of this study is to assess the oxidative stress status in patients requiring intensive care unit (ICU) admission before initiating ICU treatment, by measuring the total oxidant level (TOS) and total antioxidant level (TAS) and oxidative stress index (OSI) levels. [...] Read more.
Objectives: The aim of this study is to assess the oxidative stress status in patients requiring intensive care unit (ICU) admission before initiating ICU treatment, by measuring the total oxidant level (TOS) and total antioxidant level (TAS) and oxidative stress index (OSI) levels. Additionally, we aim to explore the correlation between these oxidative stress markers and biochemical and hematological parameters. Materials and Methods: A total of 153 patients treated in intensive care units were included in the study. Patients who met the patient admission criteria of the ethics committee of the intensive care medicine association were included in the study. Blood samples were taken at the first moment the patients were admitted to the intensive care unit (before starting treatment). In total, 60 healthy volunteers who were compatible with the patient group in terms of age and gender were included in the study as a control group. Patients who had previously received antioxidant treatment and cancer patients were excluded from the study. Results: The TOS was significantly higher in the patient group (13.4 ± 7.5) compared to controls (1.8 ± 4.4) (p = 0.021). TOS > 12.00 means a “very high oxidant level”. OSI was significantly higher in the patient group (689.8 ± 693.9) compared to the control group (521.7 ± 546.6) (p = 0.035). Ferritin levels were significantly higher in the patient group (546.5 ± 440.8 ng/mL) compared to controls (45.5 ± 46.5 ng/mL) (p < 0.001). Patients had significantly higher levels of C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBCs), immature granulocytes (IGs), zinc, and copper compared to the control group, indicating elevated inflammation and oxidative stress. CRP levels were 76.6 ± 85.9 mg/L in patients versus 5.6 ± 15.1 mg/L in controls (p < 0.001). PCT levels were 15.8 ± 8.6 ng/L in patients versus 2.3 ± 7.2 ng/L in controls (p = 0.012). Zinc and copper were also significantly elevated (p = 0.012 and p = 0.002, respectively). Conclusions: Our study provides valuable insights into the relationship between oxidative stress, inflammation, and trace elements, contributing to the growing understanding of oxidative stress as a prognostic tool in critical care. This could help to tailor therapeutic strategies aimed at reducing oxidative damage in ICU patients, enhancing patient outcomes. Full article
(This article belongs to the Section Intensive Care)
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13 pages, 2531 KB  
Article
New Neutrophil Parameters in Diseases with Various Inflammatory Processes
by Elżbieta Rutkowska, Iwona Kwiecień, Agata Raniszewska, Rafał Sokołowski, Joanna Bednarek, Karina Jahnz-Różyk, Andrzej Chciałowski and Piotr Rzepecki
Biomedicines 2024, 12(9), 2016; https://doi.org/10.3390/biomedicines12092016 - 4 Sep 2024
Cited by 5 | Viewed by 2715
Abstract
The neutrophils evaluation seems interesting in the initial qualifications of patients with various inflammatory processes. In this study, we presented analysis of neutrophils and new parameters of the complexity (NEUT-GI, NE-WX), maturation (IG), size (NE-FSC, NE-WZ), and neutrophil activities (NEUT-RI, NE-WY) in coronavirus [...] Read more.
The neutrophils evaluation seems interesting in the initial qualifications of patients with various inflammatory processes. In this study, we presented analysis of neutrophils and new parameters of the complexity (NEUT-GI, NE-WX), maturation (IG), size (NE-FSC, NE-WZ), and neutrophil activities (NEUT-RI, NE-WY) in coronavirus disease 2019 (COVID-19), lung cancer (LC), sarcoidosis (SA), and healthy controls (HCs). Peripheral blood (PB) was collected. The new parameters were examined by the Sysmex XN-1500. The mean absolute value for the IG parameter was the highest in the LC group. The differences in NEUT-RI value between COVID-19 and the HC group were observed. No significant differences were noticed between groups in the NEUT-GI granularity parameter. Neutrophil size assessed by NE-FSC parameter was reduced in all groups compared to HCs. The values of complexity (NE-WX), fluorescence (NE-WY), and size (NE-WZ) were the lowest in the HCs, whereas the highest median proportions of NE-WX, NE-WY, and NE-WZ were in LC patients. Patients from the SA group differed significantly from the HC group only for the NE-WZ parameter. We showed the usefulness of neutrophil parameters and their reactivity, morphology, and exhaustion. A more detailed analysis of blood counts may reveal trends that indicate a disease-specific immune response. Full article
(This article belongs to the Special Issue Neutrophils, Fast and Strong 2.0)
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18 pages, 1931 KB  
Article
Analysis and Interpretation of Automated Blood Count in the Treatment of Chronic Paracoccidioidomycosis
by Eliana da Costa Alvarenga de Brito, Adriana de Oliveira França, Igor Valadares Siqueira, Vinícius Lopes Teodoro Félix, Amanda Alves Rezende, Bárbara Casella Amorim, Suzane Eberhart Ribeiro da Silva, Rinaldo Poncio Mendes, Simone Schneider Weber and Anamaria Mello Miranda Paniago
J. Fungi 2024, 10(5), 317; https://doi.org/10.3390/jof10050317 - 27 Apr 2024
Viewed by 1766
Abstract
Blood count is crucial for assessing bone marrow’s cell production and differentiation during infections, gaging disease severity, and monitoring therapeutic responses. The profile of blood count in chronic forms of paracoccidioidomycosis (PCM) has been insufficiently explored. To better understand the changes in hematological [...] Read more.
Blood count is crucial for assessing bone marrow’s cell production and differentiation during infections, gaging disease severity, and monitoring therapeutic responses. The profile of blood count in chronic forms of paracoccidioidomycosis (PCM) has been insufficiently explored. To better understand the changes in hematological cells in different stages of the PCM chronic form, we evaluated the blood count, including immature blood cells in automated equipment, before and during the treatment follow-up of 62 chronic PCM patients. Predominantly male (96.8%) with an average age of 54.3 (standard deviation SD 6.9) years, participants exhibited pre-treatment conditions such as anemia (45.2%), monocytosis (38.7%), and leukocytosis (17.7%), which became less frequent after clinical cure. Anemia was more prevalent in severe cases. Notably, hemoglobin and reticulocyte hemoglobin content increased, while leukocytes, monocytes, neutrophils, immature granulocytes, and platelets decreased. Chronic PCM induced manageable hematological abnormalities, mainly in the red blood series. Monocytosis, indicating monocytes’ role in PCM’s immune response, was frequent. Post-treatment, especially after achieving clinical cure, significant improvements were observed in various hematological indices, including immature granulocytes and reticulocyte hemoglobin content, underscoring the impact of infection on these parameters. Full article
(This article belongs to the Special Issue New Insights into Paracoccidioides and Paracoccidioidomycosis)
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