Burn Patients: White Blood Cell Motility Predictive of Sepsis

Daniel Irimia, M.D., Ph.D. Assistant Professor  Division of Surgery, Science & Bioengineering Massachusetts General Hospital and Harvard Medical School Associate Director, BioMEMS Resource Center Boston, MA 02129MedicalResearch.com Interview with:
Daniel Irimia, M.D., Ph.D.
Assistant Professor
Division of Surgery, Science & Bioengineering
Massachusetts General Hospital and Harvard Medical School
Associate Director, BioMEMS Resource Center
Boston, MA 02129

Medical Research: What is the background for this study? What are the main findings?

Response: Sepsis is affecting more than half of the patients with major burn injuries (20 percent of body surface) and is the leading cause of death among these patients.  Sepsis is also a significant complication for other critically ill patients. More than one million Americans are affected and it has been estimated that approximately 30% of these people die, despite significant advances in life support and antibiotics.  Early diagnosis is essential, and it has been calculated that every 6 hours of delay in a sepsis diagnosis decreases the chances of survival by 10 percent.

We have found that the motility of the white blood cells called neutrophils, inside a microfluidic device, is significantly altered two to three days before sepsis develops.

Medical Research: What should clinicians and patients take away from your report?

Response: Clinicians already know that neutrophils are important in the context of infections.  In fact, the absolute neutrophil count (ANC) is today one of the most common blood tests, ordered for all patients and healthy individuals.  However, just relying on the absolute number (of neutrophils) could be misleading and limiting.  We show that neutrophils could become defective in their functional abilities in burns and that may be true in other conditions.  We also show that neutrophils are more sensitive than previously appreciated and could respond very early to sepsis.  Overall, new technologies are emerging to bring new information about neutrophil function into the hands of clinicians, beyond just the simple neutrophil counts, and this information will likely be important in clinical context.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Neutrophils are emerging as playing much more important roles in sepsis than has been previously appreciated. Novel technologies are needed to probe neutrophil functions with better precision than ever before, and to employ the neutrophils towards better approaches to diagnosing, monitoring and preventing sepsis.

Citation:

Caroline N. Jones, Molly Moore, Laurie Dimisko, Andrew Alexander, Amir Ibrahim, Bryan A. Hassell, H. Shaw Warren, Ronald G. Tompkins, Shawn P. Fagan, Daniel Irimia. Spontaneous Neutrophil Migration Patterns during Sepsis after Major Burns. PLoS ONE, 2014; 9 (12): e114509 DOI: 10.1371/journal.pone.0114509