The Functional State of Neutrophils Correlates With the Severity of Renal Dysfunction in Children With Hemolytic Uremic Syndrome

摘要

Hemolytic Uremic Syndrome (HUS) is the main cause of acute renal failure in children. The high percentage of patients who develop long-term sequelae constitutes an important medical concern. The identification of parameters that correlate with the degree of renal failure may be useful to plan the best treatment soon after hospitalization. Here, we investigated the functional state of neutrophils (PMN) from HUS patients on admission, before dialysis and/or transfusion, in relation to the severity of renal impairment reached during the acute period (AP). We found that all PMN activation parameters measured in severe cases of HUS (HUS AP3) were statistically lower comparing to children with mild cases of HUS (HUS AP1). As HUS PMN phenotype and dysfunction is compatible with that of cells undergoing cell death, we also studied spontaneous apoptosis. Not only were HUS PMN not apoptotic, but HUS AP3 PMN showed an increased survival. Almost all phenotypic and functional parameters measured on PMN correlated with severity. Our results revealed a marked deactivation of PMN in severe cases of HUS, and suggest that studying the functional state of PMN could be of prognostic value.Abbreviations: PMN, neutrophils; HUS, Hemolytic Uremic Syndrome; AP, acute period; HUS AP1, mild cases of HUS; HUS AP2, moderate cases of HUS; HUS AP3, severe cases of HUS; HC, healthy control; Stx, Shiga toxin; STEC, Stx-producing Escherichia coli; ROS, reactive oxygen species; MPO, myeloperoxidase; FITC, fluorescein isothiocyanate; DHR, dihydrorhodamine 123; PMA, phorbol myristate acetate