Olfactomedin 4⇓positive neutrophils are upregulated after hemorrhagic shock

Al Faraaz Kassam, Nick C. Levinsky, Jaya P. Mallela, Kira Angel, Amy Opoka, Patrick Lahni, Rashmi D. Sahay, Lin Fei, Vanessa Nomellini, Hector R. Wong, Matthew N. Alder

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Neutrophils are vital to both the inflammatory cascade and tissue repair after an injury. Neutrophil heterogeneity is well established but there is less evidence for significant, different functional roles for neutrophil subsets. OLFM4 (Olfactomedin-4) is expressed by a subset of neutrophils, and high expression of OLFM4 is associated with worse outcomes in patients with sepsis and acute respiratory distress syndrome. We hypothesized that an increased number of OLFM41 neutrophils would occur in trauma patients with worse clinical outcomes. To test this, we prospectively enrolled patients who suffered a blunt traumatic injury. Blood was collected at the time of admission, Day 3, and Day 7 and analyzed for the percentage of neutrophils expressing OLFM4. We found that a subset of patients who suffered blunt traumatic injury upregulated their percentage of OLFM41 neutrophils. Those who upregulated their OLFM4 had an increased length of stay, days in the ICU, and ventilator days. A majority of these patients also suffered from hemorrhagic shock. To establish a potential role for OLFM41 neutrophils, we used a murine model of hemorrhagic shock because mice also express OLFM4 in a subset of neutrophils. These studies demonstrated that wild type mice had higher concentrations of cytokines in the plasma and myeloperoxidase in the lungs compared with OLFM4-null mice. In addition, we used an anti-OLFM4 antibody, which when given to wild type mice led to the reduction of myeloperoxidase in the lungs of mice. These findings suggest that OLFM41 neutrophils are a unique subset of neutrophils that affect the inflammatory response after tissue injury.

Original languageEnglish (US)
Pages (from-to)216-223
Number of pages8
JournalAmerican journal of respiratory cell and molecular biology
Issue number2
StatePublished - 2021
Externally publishedYes


  • Blunt traumatic injury
  • Hemorrhagic shock
  • Neutrophils
  • Olfactomedin 4
  • Trauma

ASJC Scopus subject areas

  • Molecular Biology
  • Pulmonary and Respiratory Medicine
  • Clinical Biochemistry
  • Cell Biology


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