flavin-adenine-dinucleotide and Acute-Disease

Although blood neutrophils with toxic granulation provide an excellent means of evaluating acute bacterial infections, the methods are labor-intensive and their reproducibilities depend on the staining technique and the observer's judgment. We measured the flavin adenine dinucleotide (FAD) content of normal neutrophils and neutrophils with toxic granulation by flow cytometry after incubating them with bis(Zn(2+)-dipicolylamine) complex. A total of 122 blood samples (78 with neutrophils with toxic granulation, 44 with normal neutrophils without toxic granulation) were analyzed. The mean autofluorescence levels of neutrophils in the toxic granulation (+) group and toxic granulation (-) group were both 1.9 x 10(3) MESF (mean equivalent soluble fluorochrome) values. However, after incubating neutrophils with bis(Zn(2+)-dipicolylamine) complex for 15 min, the mean fluorescence intensities of neutrophils in the toxic granulation (+) and toxic granulation (-) groups were significantly enhanced by 71- and 19-fold to 138+/-78 x 10(3) MESF and 37+/-37 x 10(3) MESF, respectively (p <0.001). An MESF cutoff value of 79 x 10(3) showed a sensitivity of 93.2% and a specificity of 81.8% for neutrophils with toxic granulation. Similarly, the MESF level ratio, defined as the ratio of the MESF value after incubation with bis(Zn(2+)-dipicolylamine) complex to the autofluorescence MESF value, at a cutoff value of 41, showed a sensitivity of 92.3% and a specificity of 81.8% for the detection of neutrophils with toxic granulation. The MESF values of neutrophils after incubation with bis(Zn(2+)-dipicolylamine) complex did not correlate with the leukocyte (p >0.05) or neutrophil counts (p >0.05). In conclusion, measurement of FAD fluorescence intensity in neutrophils by flow cytometry after incubation with bis(Zn(2+)-dipicolylamine) complex is an easy, objective, and reliable method of detecting neutrophils with toxic granulation.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Amines; Bacterial Infections; Child; Female; Flavin-Adenine Dinucleotide; Granuloma; Hematopoietic Stem Cell Transplantation; Humans; Indicators and Reagents; Leukemia; Leukocyte Count; Male; Middle Aged; Neutrophils; Picolinic Acids; Sepsis; Young Adult

The tryptic FAD-peptide carrying the flavin in 8alpha-(N3)histidyl linkage as natural hapten was isolated by HPLC from the bacterial enzyme 6-hydroxy-d-nicotine oxidase. The same flavin protein linkage is found in the mitochondrial succinate dehydrogenase flavoprotein subunit, the predominant flavoprotein with covalently bound FAD in mitochondria of cardiomyocytes. Peripheral blood mononuclear cells (PBMC) were isolated from four patients with acute myocarditis, seven patients with dilated cardiomyopathy (DCM) and from four healthy control individuals. The response of PBMC to the FAD-peptide was evaluated by measuring proliferation ([3H]-dThd incorporation) and cytokine secretion [interferon (IFN)-gamma]. PBMC from all patients with acute myocarditis showed positive responses to the FAD-peptide, in contrast to PBMC from patients with DCM or control individuals. Following the recovery of the patients from the acute inflammation of the heart, PBMC no longer exhibited a proliferation response to the FAD-peptide. A chemically synthesized FAD-free peptide with identical amino acid sequence induced no response of PBMC. The results are consistent with a recall response by activated T cells, specific for the normally cryptic mitochondrial flavin-hapten, which may be liberated following cardiomyocyte destruction during the inflammation of the heart.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Cardiomyopathy, Dilated; Case-Control Studies; Cell Division; Cells, Cultured; Enterotoxins; Female; Flavin-Adenine Dinucleotide; Haptens; Humans; Interferon-gamma; Lymphocyte Activation; Male; Middle Aged; Mitochondria, Heart; Myocarditis; Phytohemagglutinins; T-Lymphocytes; Tetanus Toxoid; Time Factors

Topics: Acute Disease; Adenosine Triphosphate; Animals; Bile; Cytochrome c Group; Cytochromes; Flavin-Adenine Dinucleotide; Glutamates; Hydrogen-Ion Concentration; Liver; Male; Mitochondria, Liver; NAD; Oxidative Phosphorylation; Oxygen Consumption; Pancreatitis; Rabbits; Succinates; Time Factors