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. 2011;15(1):R31.
doi: 10.1186/cc9978. Epub 2011 Jan 18.

High levels of circulating leukocyte microparticles are associated with better outcome in acute respiratory distress syndrome

Christophe Guervilly  1 , Romaric Lacroix, Jean-Marie Forel, Antoine Roch, Laurence Camoin-Jau, Laurent Papazian, Françoise Dignat-George
Affiliations

High levels of circulating leukocyte microparticles are associated with better outcome in acute respiratory distress syndrome

Christophe Guervilly et al. Crit Care. 2011.

Abstract

Introduction: The current study has addressed the presence and the cellular origin of microparticles (MP) isolated from bronchoalveolar lavage (BAL) fluid and from blood samples from patients with acute respiratory distress syndrome (ARDS). Their prognostic interest was also investigated.

Methods: Fifty-two patients were included within the first 24 hours of ARDS. They were compared to spontaneous breathing (SB) and ventilated control (VC) groups. Bronchoalveolar lavage (BAL) and blood samples were obtained on Day 1 and Day 3 in an ARDS group. Leukocyte microparticles (LeuMP), neutrophil microparticles (NeuMP), endothelial microparticles (EMP), and platelet microparticles (PMP) were measured in arterial blood and in BAL samples by flow cytometry. Mortality from all causes was recorded at Day 28.

Results: All MP subpopulations were detected in BAL. However, only LeuMP and NeuMP were elevated in ARDS patients compared to the SB group (P = 0.002 for both). Among ARDS patients, higher levels of LeuMP were detected in blood (Day 1) and in BAL (Day 3) in survivors as compared with the non survivors. Circulating LeuMP >60 elements/microliter detectable on Day 1 of ARDS, was associated with a higher survival rate (odds ratio, 5.26; 95% confidence interval, 1.10 to 24.99; P = 0.037).

Conclusions: The identification of the cellular origin of microparticles at the onset of ARDS has identified LeuMP as a biomarker of prognostic significance. The higher levels of LeuMP in survivors could be associated with a protective role of this MP subpopulation. This hypothesis needs further investigations.

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Figures

Figure 1
Figure 1
Levels of LeuMP from BAL in ARDS patients and controls groups. LeuMP, leukocyte microparticles; SB group, spontaneous breathing group; VC group, ventilated control group; Levels of MP are expressed as the number of elements per microliter (μL). Box plots represent median, interquartile range, 10th to 90th percentiles.
Figure 2
Figure 2
Levels of NeuMP from BAL in ARDS patients and controls groups. NeuMP, neutrophil microparticles; SB group, spontaneous breathing group; VC group, ventilated control group; Levels of MP are expressed as the number of elements per microliter (μL). Box plots represent median, interquartile range, 10th to 90th percentiles.
Figure 3
Figure 3
Levels of circulating microparticles between survivors and non survivors. LeuMP, leukocyte microparticles; NeuMP, neutrophil microparticles; PMP, platelet microparticles; EMP, endothelial microparticles. P-values were calculated by Wilcoxon rank-sum test. Box plots represent median, interquartile range, 10th to 90th percentiles.
Figure 4
Figure 4
Short terms variations of leukocyte and neutrophil microparticle in broncho-alveolar lavage. LeuMP, leukocyte microparticles; NeuMP, neutrophil microparticles; BAL, bronchoalveolar lavage. Empty circles represent survivors and full triangles represent the non survivors. The dotted line connects the median values of MP in survivors and the solid line connects the median values of MP in non survivors. P-values compare survivors vs non survivors and were calculated by Wilcoxon rank-sum test.
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