Features of peripheral blood B cell phenotype in patients with pressure ulcers

Cover Page


Cite item

Full Text

Abstract

Pressure ulcers represent most common surgical pathology in the pattern of nosocomial complications. However, no unified mechanism leading to development of pressure ulcers has been proposed yet despite the lead role played by compression and immobilization. In this regard, examining immune system as the main component maintaining integrity of anatomical barriers in the skin and mucous membranes seems highly promising for creating new methods to prevent and treat pressure ulcers. Our study was aimed at investigating phenotypic profile of peripheral blood B cells in patients with pressure ulcers. There were enrolled 67 patients complicated with pressure ulcers at the Department of Surgery. Examination of pressure ulcers included determining anatomical localization, investigating depth (degree) and size of the lesion (by measuring wound area), skin color and assessing nature of pressure ulcer edges and edema, wound bottom, presence of cavity with tendons and/or bone formations may be recognized therein, characteristics of exudate (smell, color), pain sensation. In control group there were included 81 apparently healthy subjects. All groups contained age- and sex-matched subjects. Phenotyping of peripheral blood B cells was performed by using flow cytometry with panel of monoclonal antibodies. It was found that count of B cells in patients did not change in parallel with increased total lymphocyte count, but was associated with their functional activity (increased percentage of CD23- and CD38-positive B cells). Moreover, percentage of B1 and naive B2 cells declined in patients with pressure ulcers that seemed to be associated with the premorbid background of the main disease, lack of adequate wound healing process coupled to tissue necrosis and damage to skin capillaries. The more severe the clinical course of pressure ulcers (regarding area and stage of development), the smaller percentage of B2 cells (both naive and memory B cell subsets) was detected in the patient peripheral blood. At the same time, changes in the B cell phenotypic profile from patients are associated with the area of lesion, but not with the stage of developing pressure ulcers evidencing that B cells affect healing of pressure ulcers. The features of B cell phenotype promote unfavorable disease outcome evidenced by the lack of quantitative differences in B cell lineage composition or level of surface expression for activation markers.

About the authors

S. A. Borisov

Research Institute of Medical Problems of the North, Krasnoyarsk Research Center, Siberian Branch, Russian Academy of Sciences; I. Berzon Krasnoyarsk Interdistrict Clinical Hospital No. 20

Email: fake@neicon.ru

Postgraduate Student, Laboratory of Cellular and Molecular Physiology and Pathology

Krasnoyarsk

Russian Federation

A. A. Savchenko

Research Institute of Medical Problems of the North, Krasnoyarsk Research Center, Siberian Branch, Russian Academy of Sciences

Email: fake@neicon.ru

PhD, MD (Medicine), Professor, Head, Laboratory of Cellular and Molecular Physiology and Pathology

Krasnoyarsk

Russian Federation

E. V. Kasparov

Research Institute of Medical Problems of the North, Krasnoyarsk Research Center, Siberian Branch, Russian Academy of Sciences

Email: fake@neicon.ru

PhD, MD (Medicine), Professor, Director

Krasnoyarsk

Russian Federation

V. A. Fokin

I. Berzon Krasnoyarsk Interdistrict Clinical Hospital No. 20

Email: fake@neicon.ru

Physician

Krasnoyarsk

Russian Federation

M. V. Matsenko

Research Institute of Medical Problems of the North, Krasnoyarsk Research Center, Siberian Branch, Russian Academy of Sciences; I. Berzon Krasnoyarsk Interdistrict Clinical Hospital No. 20

Email: fake@neicon.ru

Postgraduate Student, Laboratory of Cellular and Molecular Physiology and Pathology

Krasnoyarsk

Russian Federation

I. V. Kudryavtsev

Institute of Experimental Medicine; First St. Petersburg State I. Pavlov Medical University

Author for correspondence.
Email: igorek1981@yandex.ru

Kudryavtsev Igor V. - PhD (Biology), Senior Research Associate, Department of Immunology; Associate Professor, Department of Immunology

197376, St. Petersburg, Acad. Pavlov str., 12

Phone: 7 (812) 234-68-68

Fax: 7 (812) 234-94-89

Russian Federation

A. G. Borisov

Research Institute of Medical Problems of the North, Krasnoyarsk Research Center, Siberian Branch, Russian Academy of Sciences

Email: fake@neicon.ru

PhD (Medicine), Leading Research Associate, Laboratory of Cellular and Molecular Physiology and Pathology

Krasnoyarsk

Russian Federation

References

  1. Борисов А.Г. Клиническая характеристика нарушения функции иммунной системы // Медицинская иммунология, 2013. Т. 15, № 1. С. 45-50. [Borisov A.G. Clinical characterization of functional disorders affecting immune system. Meditsinskaya immunologiya = Medical Immunology (Russia), 2013, Vol. 15, no. 1, pp. 45-50. (In Russ.)] doi: 10.15789/1563-0625-2013-1-45-50.
  2. Борисов А.Г., Савченко А.А., Соколовская В.К. Заболеваемость, связанная с нарушениями функции иммунной системы (на примере Красноярского края) // Здравоохранение Российской Федерации, 2014. Т. 58, № 6. С. 38-41. [Borisov A.G., Savchenko A.A., Sokolovskaya V.K. Morbidity associated with dysfunctions of the immune system (on the example of the Krasnoyarsk Territory). Zdravookhranenie Rossiyskoy Federatsii = Health Care of the Russian Federation, 2014, Vol. 58, no. 6, pp. 38-41. (In Russ.)]
  3. Борисов А.Г., Савченко А.А., Черданцев Д.В., Здзитовецкий Д.Э., Первова О.В., Кудрявцев И.В., Беленюк В.Д., Шапкина В.А. Типы иммунного реагирования при распространенном гнойном перитоните // Хирургия им. Н.И. Пирогова, 2016. № 9. С. 28-34. [Borisov A.G., Savchenko A.A., Cherdantsev D.V., Zdzitovetsky D.E., Pervova O.V., Kudryavtsev I.V., Belenyuk V.D., Shapkina V.A. Types of immune response in advanced suppurative peritonitis. Khirurgiya. Zhurnal imeni N.I. Pirogova = Pirogov Russian Journal of Surgery, 2016, no. 9, pp. 28-34. (In Russ.)]
  4. Борисов С.А., Савченко А.А., Каспаров Э.В., Маценко М.В., Кудрявцев И.В. Типы иммунного реагирования при пролежнях // Российский иммунологический журнал, 2019. Т. 13 (22), № 4. С. 1432-1434. [Borisov S.A., Savchenko A.A., Kasparov E.V., Matsenko M.V., Kudryavtsev I.V. Types of immune response in pressure ulcers. Rossiyskiy immunologicheskiy zhurnal = Russian Journal of Immunology, 2019, Vol. 13 (22), no. 4, pp. 1432-1434. (In Russ.)]
  5. Борисов С.А., Каспаров Э.В., Маценко М.В. Клинико-иммунологические аспекты развития пролежней // Современные проблемы науки и образования, 2017. № 5. С. 111-121. [Borisov S.A., Kasparov E.V., Matsenko M.V. Clinical and immunological aspects of the development of pressure ulcers. Sovremennye problemy nauki i obrazovaniya = Modern Problems of Science and Education, 2017, no. 5, pp. 111-121. (In Russ.)]
  6. Савченко А.А., Борисов А.Г., Здзитовецкий Д.Э., Лузан Н.А. Особенности состояния клеточного и гуморального иммунитета у больных распространенным гнойным перитонитом // Бюллетень Восточносибирского научного центра Сибирского отделения Российской академии медицинских наук, 2012. № 3 (85). Ч. 2. С.159-163. [Savchenko A.A., Borisov A.G., Zdzitovetsky D.E., Luzan N.A. Features of the state of cellular and humoral immunity in patients with widespread purulent peritonitis. Byulleten Vostochno-sibirskogo nauchnogo tsentra Sibirskogo otdeleniya Rossiyskoy akademii meditsinskikh nauk. = Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences, 2012, no. 3 (85), Pt. 2, pp. 159-163. (In Russ.)]
  7. Савченко А.А., Каспаров Э.В., Арутюнян С.С., Борисов А.Г., Кудрявцев И.В., Мошев А.В. Фенотипический состав В-лимфоцитов у женщин с хроническим эндометритом и аднекситом // Медицинская иммунология, 2016. Т. 18, № 4. С. 379-384. [Savchenko A.A., Kasparov E.V., Arutyunyan S.S., Borisov A.G., Kudryavtsev I.V., Moshev A.V. Phenotypic profile of B-lymphocytes in women with chronic endometritis and adnexitis. Meditsinskaya immunologiya = Medical Immunology (Russia), 2016, Vol. 18, no. 4, pp. 379-384. (In Russ.)] doi: 10.15789/1563-0625-2016-4-379-384.
  8. Хайдуков С.В., Байдун Л.А., Зурочка А.В., Тотолян Арег А. Стандартизованная технология «Исследование субпопуляционного состава лимфоцитов периферической крови с применением проточных цитофлюориметров-анализаторов» (Проект) // Медицинская иммунология, 2012. Т. 14, № 3. С. 255-268. [Khaydukov S.V., Baydun L.A., Zurochka A.V., Totolian Areg A. Standardized technology “Research of lymphocytes subpopulation composition in peripheral blood using flow cytometry analyzers” (Draft). Meditsinskaya immunologiya = Medical Immunology (Russia), 2012, Vol. 14, no. 3, pp. 255-268. (In Russ.)] doi: 10.15789/1563-0625-2012-3-255-268.
  9. Bone R.S., Balk R.A.B., Cerra F.B. American college of Chest Physicians. Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guide lines for the use of innovative therapies in sepsis. Crit. Care Med., 1992, Vol. 20, no. 6, pp. 864-874.
  10. Coleman S., Nixon J., Keen J., Wilson L., McGinnis E., Dealey C., Stubbs N., Farrin A., Dowding D., Schols J.M., Cuddigan J., Berlowitz D., Jude E., Vowden P., Schoonhoven L., Bader D.L., Gefen A., Oomens C.W., Nelson E.A. A new pressure ulcer conceptual framework. J. Adv. Nurs., 2014, Vol. 70, no. 10, pp. 2222-2234.
  11. Edsberg L.E., Black J.M., Goldberg M., McNichol L., Moore L., Sieggreen M. Revised national pressure ulcer advisory panel pressure injury staging system: revised pressure injury staging system. J. Wound Ostomy Continence Nurs., 2016, Vol. 43, no. 6, pp. 585-597.
  12. Fonder M.A., Lazarus G.S., Cowan D.A., Aronson-Cook B., Kohli A.R., Mamelak A.J. Treating the chronic wound: a practical approach to the care of nonhealing wounds and wound care dressings. J. Am. Acad. Dermatol., 2008, Vol. 58, pp. 185-206.
  13. Geiger B., Wenzel J., Hantschke M., Haase I., Stander S., von Stebut E. Resolving lesions in human cutaneous leishmaniasis predominantly harbour chemokine receptor CXCR3-positive T helper 1/T cytotoxic type 1 cells. Br. J. Dermatol., 2010, Vol. 162, pp. 870-874.
  14. Goldman R. Growth factors and chronic wound healing: past, present, and future. Adv. Skin Wound Care, 2004, Vol. 17, pp. 24-35.
  15. Jaul E., Barron J., Rosenzweig J.P., Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr., 2018, Vol. 18, no. 1, pp. 305.
  16. Kato T., Fahrmann J.F., Hanash S.M., Vykoukal J. Extracellular vesicles mediate B cell immune response and are a potential target for cancer therapy. Cells, 2020, Vol. 9, no. 6, 1518. doi: 10.3390/cells9061518.
  17. Lafyatis R., Kissin E., York M., Farina G., Viger K., Fritzler M.J., Merkel P.A., Simms R.W. B cell depletion with rituximab in patients with diffuse cutaneous systemic sclerosis. Arthritis Rheum., 2009, Vol. 60, pp. 578-583.
  18. le Gall J.-R., Lemeshow S., Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA, 1993, Vol. 270, pp. 2957-2963.
  19. Lima J., Cambridge G., Vilas-Boas A., Martins C., Borrego L.M., Leandro M. Serum markers of B-cell activation in pregnancy during late gestation, delivery, and the postpartum period. Am. J. Reprod. Immunol., 2019, Vol. 81, no. 3, e13090. doi: 10.1111/aji.13090.
  20. National Pressure Ulcer Advisory Panel 2019 Award Recipients. Adv. Skin Wound Care, 2019, Vol. 32, Iss. 6, p. 252.
  21. Romero-Ramírez H., Morales-Guadarrama M.T., Pelayo R., López-Santiago R., Santos-Argumedo L. CD38 expression in early B-cell precursors contributes to extracellular signal-regulated kinase-mediated apoptosis. Immunology, 2015, Vol. 144, no. 2, pp. 271-281.
  22. Simon D., Hosli S., Kostylina G., Yawalkar N., Simon H.U. Anti-CD20 (rituximab) treatment improves atopic eczema. J. Allergy Clin. Immunol., 2008, Vol. 121, pp. 122-128.
  23. Szczepanik M., Akahira-Azuma M., Bryniarski K., Tsuji R.F., Kawikova I., Ptak W., Kiener C., Campos R.A., Askenase P.W. B-1 B cells mediate required early T cell recruitment to elicit protein-induced delayed-type hypersensitivity. J. Immunol., 2003, Vol. 171, pp. 6225-6235.
  24. Tsuji R.F., Szczepanik M., Kawikova I., Paliwal V., Campos R.A., Itakura A., Akahira-Azuma M., Baumgarth N., Herzenberg L.A., Askenase P.W. B cell-dependent T cell responses: IgM antibodies are required to elicit contact sensitivity. J. Exp. Med., 2002, Vol. 196, 1277-1290.
  25. Vincent J.L., Moreno R., Takala J., Willatts S., De Mendonça A., Bruining H., Reinhart C.K., Suter P.M., Thijs L.G. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med., 1996, Vol. 22, no. 7, pp. 707-710.
  26. Wang Y., Liu J., Burrows P.D., Wang J.Y. B cell development and maturation. Adv. Exp. Med. Biol., 2020, Vol. 1254, pp. 1-22.
  27. Zhao R., Liang H., Clarke E., Jackson C., Xue M.J. Inflammation in chronic wounds. Int. J. Mol. Sci., 2016, Vol. 17, 2085. doi: 10.3390/ijms17122085.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2020 Borisov S.A., Savchenko A.A., Kasparov E.V., Fokin V.A., Matsenko M.V., Kudryavtsev I.V., Borisov A.G.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № 77 - 11525 от 04.01.2002.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies