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Neutrophil and monocyte receptor expression in uncomplicated and complicated influenza A infection with pneumonia

Following influenza, the elderly and those with chronic heart/lung diseases are often affected by bacterial complications such as pneumonia. Whether neutrophil and monocyte functions are affected differently in patients with or without complications is less well known. Therefore, blood neutrophil and monocyte surface receptor expressions were measured in patients with influenza A, with or without complications, by means of flow cytometry. Neutrophil expressions of the adhesion molecules CD11b and CD66b were increased in influenza A, with the highest expression of CD11b in uncomplicated influenza. Monocyte expressions of CD11b and CD18 were also higher in influenza compared with bacterial infection and healthy controls. Neutrophil expressions of the phagocyte receptors CD64 and CD32 and the complement receptor CD35 were impaired in influenza with and without pneumonia compared with bacterial infection, whereas the expressions in monocytes were increased in all infected groups. The expression of the phagocyte receptor CD16 on neutrophils was impaired in all infected groups. Our results suggest increased recruitment of neutrophils and monocytes to infected areas by up-regulation of adhesion molecules in influenza that may be involved in the inflammatory response during infection. In contrast, depression of phagocyte receptor expression on neutrophils in patients with influenza pneumonia may contribute to increased susceptibility to bacterial infections and impaired clearance of encapsulated bacteria such as pneumococci.