Increase in PU.1 activity coupled with epigenetic regulation of its gene promoter. Intracellular expression of PU.1 and methylation of SPI were measured in the circulating MO. a There was a significant increase in the percentage of expression of PU.1 t0: Me = 70.76; IQR[53.16, 79.72] t24h: Me = 90.14; IQR[83.88, 92.94]; ΔRank = − 4.00; CI95% = [− 7.15, − 0.85]; p = 0.018; CLES = 0.83; t3m: Me = 94.99; IQR[94.47, 95.68]; ΔRank = − 11.00; CI95% = [− 14.15, − 7.85]; p < 0.001; CLES = 1.00. b There was also a significant increase in antigen density (MFI) at all data points t0: Me = 545.30; IQR[500.20, 638.62]; t24h: Me = 3839.20; IQR[3729.39, 3944.17]; ΔRank = − 7.00; CI95% = [− 10.15, − 3.85]; p = 0.001; CLES = 1.00; t3m: Me = 4129.11; IQR[3993.60, 4222.01]; ΔRank = − 11.00; CI95% = [− 14.15, − 7.85]; p < 0.001; CLES = 1.00. c Again, this pattern was demonstrated on the MO obtained from the same patient (grayed graph is isotype control and auto fluorescence, green is baseline while red represent patient MO PU.1 reactivity at 3 months after CPB). d There was a significant decrease in methylation of SP11 gene at 3 months t0: Me = 49.65; IQR[39.50, 70.71]; t3m: Me = 4.61; IQR[4.27, 5.56]; ΔRank = 12.00; CI95% = [5.71, 18.29]; p = 0.004; CLES = 1.00. Asterisk indicate data points which were significantly different when compared vs baseline. CI95%: 95% confidence interval for difference in sum of ranks. CI95%: ΔpMe-95% confidence interval for difference in pseudomedians. CLES: common language effect size