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Neutrophil CD64 Expression and other Laboratory Biomarkers in Discriminating Bacterial versus Non Bacterial Acute Exacerbation Chronic Obstructive Pulmonary Disease.
Egyptian Journal of Immunology 2018 January
Discriminating bacterial from nonbacterial acute exacerbation chronic obstructive pulmonary disease (AE-COPD) is difficult. In this study, we evaluated T/NK-cells' subsets in peripheral blood of both stable COPD and AE-COPD patients for identifying their rule in the pathogenesis of the disease and highlighting rule of laboratory biomarkers as total and differential leukocytic count, different T/NK lymphocytes' subsets, CD64 neutrophil expression and high sensitive C-reactive protein (CRP) in discriminating bacterial versus nonbacterial AE-COPD to limit overuse of antibiotics. The studied groups were divided into 30 patients with stable COPD disease (control group) and 30 patients with AE-COPD; of which 22 were classified as bacterial and 8 as non-bacterial AE-COPD groups. Total and differential leukocytic count (TLC), high sensitive-CRP and flow-cytometric immunophenotyping using monoclonal antibodies against CD3, CD4, CD8, CD16, CD56 and CD64 were analyzed for each group. Parameters that were significantly different between control and AE-COPD groups included peripheral blood CD64 percent expression, cytotoxic-T cells (Tc), T-helper (Th), NK, NK-T and total lymphocytes' percentages. Using same parameters to further differentiate between bacterial and non-bacterial AE-COPD patients; CRP and CD64% were highly significant between 2 groups (P < 0.001), with higher CRP level and CD64 expression in the bacterial group with mean value; 22.27 mg/L and 83.89%, respectively. A cutoff of 15mg/L and 59.5% for both CRP and CD64 expression were used to discriminate between bacterial and non-bacterial COPD patients. In conclusion, CD64 expression and high sensitive-CRP performed better than several leukocytes concentrations in discriminating bacterial versus non-bacterial AE-COPD. The percentage of CD3CD8 (Tc), CD3CD4 (Th), CD16CD56 (NK) cells were higher in AE-COPD than stable COPD.
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