The basophil activation test by flow cytometry: recent developments in clinical studies, standardization and emerging perspectives

The diagnosis of immediate allergy is mainly based upon an evocative clinical history, positive skin tests (gold standard) and, if available, detection of specific IgE. In some complicated cases, functional in vitro tests are necessary. The general concept of those tests is to mimic in vitro the contact between allergens and circulating basophils. The first approach to basophil functional responses was the histamine release test but this has remained controversial due to insufficient sensitivity and specificity. During recent years an increasing number of studies have demonstrated that flow cytometry is a reliable tool for monitoring basophil activation upon allergen challenge by detecting surface expression of degranulation/activation markers (CD63 or CD203c). This article reviews the recent improvements to the basophil activation test made possible by flow cytometry, focusing on the use of anti-CRTH2/DP(2 )antibodies for basophil recognition. On the basis of a new triple staining protocol, the basophil activation test has become a standardized tool for in vitro diagnosis of immediate allergy. It is also suitable for pharmacological studies on non-purified human basophils. Multicenter studies are now required for its clinical assessment in large patient populations and to define the cut-off values for clinical decision-making

Assessment of monocytic HLA-DR expression in ICU patients: analytical issues for multicentric flow cytometry studies

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Early Interleukin-6 and Slope of Monocyte Human Leukocyte Antigen-DR: A Powerful Association to Predict the Development of Sepsis after Major Trauma

OBJECTIVE: Major trauma is characterized by a pro-inflammatory response, followed by an immunosuppression. Recently, in trauma patients, the lack of recovery of monocyte Human Leukocyte Antigen DR (mHLA-DR, a biomarker of ICU-acquired immunosuppression) between days 1-2 and days 3-4 has been demonstrated to be independently associated with sepsis development. The main objective of this study was to determine whether early measurements of IL-6 (interleukin-6) and IL-10 plasma concentrations (as markers of initial severity) could improve, in association with mHLA-DR recovery, the prediction of sepsis occurrence in severe trauma patients. DESIGN: Prospective observational study over 24 months in a Trauma ICU at university hospital. PATIENTS: Trauma patients with an ISS over 25 and age over 18 were included. MEASUREMENTS AND MAIN RESULTS: mHLA-DR was assessed by flow cytometry, IL-6 and IL-10 concentrations by ELISA. 100 consecutive severely injured patients were monitored (mean ISS 37±10). 37 patients developed sepsis. IL-6 concentrations and slope of mHLA-DR expression between days 1-2 and days 3-4 were significantly different between septic and non-septic patients. IL-10 was not detectable in most patients. After adjustment for usual clinical confounders, when assessed as a pair, multivariate logistic regression analysis revealed that a slope of mHLA-DR expression (days 3-4/days 1-2)≤1.1 and a IL-6 concentration ≥ 67.1 pg/ml remained highly associated with the development of sepsis (adjusted OR 18.4, 95% CI 4.9; 69.4, p = .00002). CONCLUSIONS: After multivariate regression logistic analysis, when assessed as a pair, a high IL-6 concentration and a persistent mHLA-DR decreased expression were found to be in relation with the development of sepsis with the best predictive value. This study underlines the usefulness of daily monitoring of immune function to identify trauma patients at a high risk of infection

Upregulation of the pro-apoptotic genes BID and FAS in septic shock patients

Introduction: Lymphocyte apoptosis has been suggested to play a central role in sepsis pathophysiology, and studies in animal models demonstrated that blocking this pathway improves outcome. However, no routine biomarkers of apoptosis are so far available in patients. Thus, the aim of our study was to assess the different biomarkers of apoptosis putatively usable on a routine basis in septic shock.Methods: Thirteen septic shock patients (sampled twice between days 1 to 2 and days 3 to 5 after diagnosis of shock) and 15 sex-matched and age-matched healthy controls were prospectively enrolled. Apoptosis was measured in lymphocyte subpopulations using flow cytometry (Annexin-V binding, activated caspase-3 and Bcl-2 expressions). Representative pro-apoptotic and anti-apoptotic gene expressions were assessed by quantitative reverse-transcription PCR. Monocyte HLA-DR expression and lymphocyte subpopulation cell counts were measured as markers of sepsis-induced immune dysfunctions. To test for statistical significance, the Mann-Whitney U test was used with correction by the number of tests performed.Results: Flow cytometric measurements of apoptosis in septic shock patients showed an increased Annexin-V binding on CD4+ T cells and an increased active caspase-3 expression on B cells only at days 3 to 5 (sixfold change and twofold change, respectively). Gene expression analysis showed an increased BCL-XL mRNA and anupregulation of the pro-apoptotic genes BID and FAS in septic shock patients (10-fold change and fivefold change, respectively) compared with healthy controls.Conclusions: The present study highlights the difficulties encountered in monitoring apoptosis on a routine basis in septic patients, whereas in the same sampling conditions and on the same patients, HLA-DR expression and lymphocyte subpopulation cell counts showed characteristics described in the literature. However, pro-apoptotic genes BID and FAS appear to constitute promising apoptosis markers in our hands

Temperature Imaging using Quadriwave Shearing Interferometry. Applications in Thermoplasmonics

International audienceThe use of illuminated gold nanoparticles as ideal nanosources of heat is the basis of numerous research activities and applications in physics, chemistry, biology and medicine. This field defines the area recently named Thermoplasmonics [1]. In most of the activities related to Thermoplasmonics, probing the temperature at the vicinity of the metal nanoparticles is not an easy task. In this context, we recently developed a novel optical microscopy technique, named TIQSI, aimed at mapping the temperature around plasmonic nanoparticles [2]. The approach is based on the measure of the thermal-induced variation of the refractive index surrounding the sources of heat. The TIQSI technique cumulates all the advantages a thermal microscopy technique may require: i) high resolution (diffraction limited), ii) high readout rate (less than one image per second), iii) high temperature sensitivity (<1°C), iv) large accessible temperature range, v) temperature can be measured without fluorescence labelling or any other kind of thermal probe, v) no need to use sophisticated devices such as heterodyne detection, acousto-optic modulator, spectrometer, etc, like previous thermal imaging techniques. In this presentation, we will first introduce the TIQSI technique, its principle and capabilities. We will then present several recent applications made it possible by this new thermal imaging technique. In particular, we shall explain how this technique have been already used to quantitatively measure the absorption cross section of gold nanoparticles [3] and graphene sheets, how it can be used to map the temperature in real time in living cells [4], how it can help to design temperature distributions at will at the microscale using gold nanoparticles [5,7], and how it can be used to investigate thermal-induced phenomena in hydro- dynamics and phase transitions [6]

Metasurface optical characterization using quadriwave lateral shearing interferometry

An optical metasurface consists of a dense and usually non-uniform layer of scattering nanostructures behaving as a continuous and extremely thin optical component, with predefined phase and intensity transmission/reflection profiles. To date, various sorts of metasurfaces (metallic, dielectric, Huygens-like, Pancharatman-Berry, etc.) have been introduced to design ultrathin lenses, beam deflectors, holograms, or polarizing interfaces. Their actual efficiencies depend on the ability to predict their optical properties and to fabricate non-uniform assemblies of billions of nanoscale structures on macroscopic surfaces. To further help improve the design of metasurfaces, precise and versatile post-characterization techniques need to be developed. Today, most of the techniques used to characterize metasurfaces rely on light intensity measurements. Here, we demonstrate how quadriwave lateral shearing interferometry (QLSI), a quantitative phase microscopy technique, can easily achieve full optical characterization of metasurfaces of any kind, as it can probe the local phase imparted by a metasurface with high sensitivity and spatial resolution. As a means to illustrate the versatility of this technique, we present measurements on two types of metasurfaces, namely Pancharatnam-Berry and effective-refractive-index metasurfaces, and present results on uniform metasurfaces, metalenses and deflectors

mRNA-based approach to monitor recombinant gamma-interferon restoration of LPS-induced endotoxin tolerance

Introduction: It is now well accepted that sepsis is associated with the development of a pronounced immunosuppressive state, characterized by severe immune alterations (e.g. reduced proliferative capacity, endotoxin tolerance, apoptosis) participating in increased mortality and susceptibility to nosocomial infections. Efforts are currently aimed at restoring a functional immune response in septic patients. Successful therapydepends on the identification of appropriate immunostimulatory drugs and on the development of suitable biomarkers that could be used to stratify patients and to follow response to treatment.Methods: In this study, we evaluated the ex vivo effect of recombinant interferon gamma (rIFN-g) in restoring monocyte functionality (endotoxin-induced Tumor Necrosis Factor-a production) in a two-hit model of endotoxin tolerance (ET) with peripheral blood mononuclear cells from healthy volunteers and in whole blood of septic shockpatients. Importantly, we used quantitative-reverse transcription polymerase-chain reaction to monitor the effect of rIFN-g on the expression of seven genes known to participate in ET (TNF-a, IL-10, HLA-DRA, CIITA, IRAK-M, ABIN-3 and LY64).Results: Expression analysis of those genes confirmed the presence of an immunosuppression state and the ex vivo restoration of immune functions by rIFN-g. We show for the first time that rIFN-g is able to bypass, at the mRNA level, the effect of negative regulators of the LPS signalling pathway such as IRAK-M, ABIN-3 and LY64.Conclusions: Overall, mRNA expressions of a panel of genes could represent promising candidates for the ex vivo evaluation of rIFN-g effect on monocyte functionality. This ex vivo translational research study demonstrates the potential of a mRNA-based approach to successfully monitor drug efficacy

Programmed death-1 levels correlate with increased mortality, nosocomial infection and immune dysfunctions in septic shock patients

International audienceINTRODUCTION: Septic shock remains a major health care problem worldwide. Sepsis-induced immune alterations are thought to play a major role in patients' mortality and susceptibility to nosocomial infections. Programmed death-1 (PD-1) receptor system constitutes a newly described immunoregulatory pathway that negatively controls immune responses. It has recently been shown that PD-1 knock-out mice exhibited a lower mortality in response to experimental sepsis. The objective of the present study was to investigate PD-1-related molecule expressions in septic shock patients. METHODS: This prospective and observational study included 64 septic shock patients, 13 trauma patients and 49 healthy individuals. PD-1-related-molecule expressions were measured by flow cytometry on circulating leukocytes. Plasmatic interleukin (IL)-10 concentration as well as ex vivo mitogen-induced lymphocyte proliferation were assessed. RESULTS: We observed that septic shock patients displayed increased PD-1, PD-Ligand1 (PD-L1) and PD-L2 monocyte expressions and enhanced PD-1 and PD-L1 CD4+ T lymphocyte expressions at day 1-2 and 3-5 after the onset of shock in comparison with patients with trauma and healthy volunteers. Importantly, increased expressions were associated with increased occurrence of secondary nosocomial infections and mortality after septic shock as well as with decreased mitogen-induced lymphocyte proliferation and increased circulating IL-10 concentration. CONCLUSIONS: These findings indicate that PD-1-related molecules may constitute a novel immunoregulatory system involved in sepsis-induced immune alterations. Results should be confirmed in a larger cohort of patients. This may offer innovative therapeutic perspectives on the treatment of this hitherto deadly disease