Increased Nucleosomes and Neutrophil Activation Link to Disease Progression in Patients with Scrub Typhus but Not Murine Typhus in Laos

PLoS Neglected Tropical Diseases
D H ParisSacha Zeerleder

Abstract

Cell-mediated immunity is essential in protection against rickettsial illnesses, but the role of neutrophils in these intracellular vasculotropic infections remains unclear. This study analyzed the plasma levels of nucleosomes, FSAP-activation (nucleosome-releasing factor), and neutrophil activation, as evidenced by neutrophil-elastase (ELA) complexes, in sympatric Lao patients with scrub typhus and murine typhus. In acute scrub typhus elevated nucleosome levels correlated with lower GCS scores, raised respiratory rate, jaundice and impaired liver function, whereas neutrophil activation correlated with fibrinolysis and high IL-8 plasma levels, a recently identified predictor of severe disease and mortality. Nucleosome and ELA complex levels were associated with a 4.8-fold and 4-fold increased risk of developing severe scrub typhus, beyond cut off values of 1,040 U/ml for nucleosomes and 275 U/ml for ELA complexes respectively. In murine typhus, nucleosome levels associated with pro-inflammatory cytokines and the duration of illness, while ELA complexes correlated strongly with inflammation markers, jaundice and increased respiratory rates. This study found strong correlations between circulating nucleosomes and neutrophil activ...Continue Reading

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Citations

Feb 2, 2018·Clinical Microbiology Reviews·Fabián E DíazAlexis M Kalergis
Mar 11, 2017·PLoS Neglected Tropical Diseases·Nicole L MendellDavid H Walker
Aug 21, 2018·Emerging Infectious Diseases·Eiichiro SandoKoya Ariyoshi
Aug 25, 2020·3 Biotech·Deepak KalaAnkur Kaushal
Oct 31, 2020·Tropical Medicine and Infectious Disease·Daniel H ParisAllen L Richards

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Methods Mentioned

BETA
biopsies
ELISA
ELISAs
biopsy

Software Mentioned

MP
Stata

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