HLA-DR Expression and Soluble HLA-DR Levels in Septic Patients After Trauma

Ditschkowski, Markus; Kreuzfelder, E.; Rebmann, Vera; Ferenčík, Stanislav; M, Majetschak; Schmid, Ernst N.; Obertacke, U.; Hirche, H.; Schade, Ulrich; Grosse‐Wilde, H.

doi:10.1097/00000658-199902000-00013

Cited by 172 publications

(119 citation statements)

References 44 publications

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“…8 Current results dovetail with a large body of work implicating a critical role of monocyte subsets and dendritic cells in the immune response to traumatic injury and surgical recovery. [20][21][22][23][24][25][26][27] The findings integrate with the well-established role of the TLR4 signaling pathway in the innate immune response to traumatic injury. 28 MAPKAPK2 is a component of the p38 MAP kinase pathway, which mediates TLR4 priming in injury.…”

Section: Discussionsupporting

confidence: 70%

Patient-Specific Immune States Before Surgery Are Strong Correlates of Surgical Recovery

Fragiadakis

Gaudillière

Ganio

et al. 2016

Survey of Anesthesiology

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Background-Recovery after surgery is highly variable. Risk-stratifying patients based on their predicted recovery profile will afford individualized perioperative management strategies. Recently, application of mass cytometry in patients undergoing hip arthroplasty revealed strong immune correlates of surgical recovery in blood samples collected shortly after surgery. However, the ability to interrogate a patient's immune state before surgery and predict recovery is highly desirable in perioperative medicine.

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Section: Discussionsupporting

confidence: 70%

Patient-Specific Immune States Before Surgery Are Strong Correlates of Surgical Recovery

Fragiadakis

Gaudillière

Ganio

et al. 2016

Survey of Anesthesiology

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“…On admission the mean age of the trauma patients ( n = 31) was 32·8 (range, 18-59), the mean ISS was 32·0 (17-59), APACHE II score of 13·5 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) and mean GCS of 8·7 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). There were 25 men and six women.…”

Section: Resultsmentioning

confidence: 99%

“…1 day after the traumatic event, was evaluated by assessment of HLA-DR expression on monocytes, a parameter known to correlate with clinical outcome in diverse populations [7][8][9][10][11][12]. In addition, the proliferative capacity of T cells and cytokine production profile upon mitogenic stimulation were evaluated, because T cells are essential for a primary immune response and were reported to be functionally compromised in traumatized patients [13,14].…”

Section: Introductionmentioning

confidence: 99%

Primary immune response to keyhole limpet haemocyanin following trauma in relation to low plasma glutamine

Boelens¹,

Fonk

Houdijk³

et al. 2004

Clinical and Experimental Immunology

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SUMMARYSevere trauma can lead to a compromised immune response, thereby increasing susceptibility to infections. Here we will study to what extent these early changes in the immune status upon trauma affect a primary immune response to keyhole limpet haemocyanin (KLH). Because glutamine is the preferred respiratory substrate for immune competent cells and known to be depleted after trauma, we studied the immune status and the primary sensitization in relation to the glutamine plasma concentration in a group of severe trauma patients [injury severity score (ISS) > 17]. Trauma patients ( n = 31) were sensitized with KLH within 12 h after trauma; plasma glutamine concentrations and immune parameters were determined, after which KLH-specific immune responsiveness was evaluated on days 9 and 14. Low plasma glutamine concentrations were found after trauma. Significantly elevated numbers of granulocytes and CD14-positive leucocytes were found, whereas the HLA-DR expression on CD14-positive cells was significantly lower in trauma patients than in healthy controls. Trauma did not change the in vitro proliferative capacity of lymphocytes when cultured with glutamine; however, when lymphocytes were cultured without glutamine, trauma resulted in lower proliferation than healthy controls. Phytohaemagglutinin-(PHA)-induced interferon (IFN)-g and interleukin (IL)-10 production was significantly lower after trauma, whereas IL-4 production was not affected. KLH sensitization following trauma resulted in poor skin test reactivity and low in vitro KLH-induced lymphocyte proliferation compared to controls. In contrast, the development of anti-KLH IgM, IgG, IgA, IgG1, IgG2, IgG3 and IgG4 production on days 9 and 14 following trauma was not different from that in healthy controls. Major trauma was associated with a reduced cell-mediated immune response, correlating with low plasma glutamine concentrations, while no effects of trauma were found on the development of a primary humoral immune response.

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“…Up to now, the decrease of mHLA-DR expression has mainly been assessed as a predictor of septic complications after trauma, surgery, or pancreatitis (28,(92)(93)(94)(95)(96)(97)(98). In these studies, low levels of mHLA-DR (<40% of positive monocytes, normal >90%) were observed in patients who subsequently developed nosocomial infections.…”

Section: Mhla-dr Expression and Clinical Studymentioning

confidence: 99%

Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Monneret

Venet

Pachot

et al. 2008

Mol Med

306

323

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HLA-DR Expression and Soluble HLA-DR Levels in Septic Patients After Trauma

Abstract: In severely injured patients, decreased levels of cellular and soluble HLA-DR appear as early indicators of an immune deviation associated with the development of severe sepsis. Moreover, immune alterations of different cell types may promote distinct kinds of septicemia.

Cited by 172 publications

References 44 publications

Patient-Specific Immune States Before Surgery Are Strong Correlates of Surgical Recovery

Patient-Specific Immune States Before Surgery Are Strong Correlates of Surgical Recovery

Primary immune response to keyhole limpet haemocyanin following trauma in relation to low plasma glutamine

Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

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