Is the measurement of monocytes HLA-DR expression useful in patients with sepsis?

Fumeaux, Thierry; Pugin, Jérôme

doi:10.1007/s00134-006-0205-7

Cited by 24 publications

(20 citation statements)

References 20 publications

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“…In adults, physiological immunodepression is protective against overwhelming inflammation, whereas excessive or prolonged immunodepression associates with increased morbidity and death [23,24]. In VLBW infants, reduced monocyte HLA-DR expression associated with risk for infections, respiratory distress syndrome, and bronchoplastic pulmonary disease, along with a clear association with gestational age [14,15], supporting the general notion that immunodepression per se may associate with adverse outcome [25].…”

Section: Discussionmentioning

confidence: 56%

Antenatal Betamethasone Associates with Transient Immunodepression in Very Low Birth Weight Infants

et al. 2013

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Background: Antenatal betamethasone (BM) treatment for mothers at risk for premature delivery is effective in reducing neonatal morbidity. Immunodepression, defined as monocyte human leukocyte antigen (HLA)-DR expression <60%, is common in patients in intensive care. In very low birth weight (VLBW) infants, immunodepression correlates with gestational age and may predispose to infections. Objectives: To evaluate whether timing of antenatal BM associates with immunodepression in VLBW infants. Methods: We determined monocyte HLA-DR expression by flow cytometry and measured 13 cytokines, cortisol, and BM in plasma from 56 VLBW infants. We calculated total glucocorticoid index as the sum of BM and cortisol at the ratio 33.3:1. Results: HLA-DR expression both in cord (R² = 0.175, p = 0.033, n = 26) and on day 1 (R² = 0.125, p = 0.011, n = 51) showed an association with timing of BM. A short interval from BM to birth induced more pronounced and prolonged immunodepression, with lower HLA-DR% on postnatal day 7. On day 3, 25 infants (45%) met the criteria of immunodepression. HLA-DR expression correlated negatively with total glucocorticoid index (cord: R² = -0.573, p = 0.003, n = 13; day 1: R² = -0.213, p = 0.008, n = 32). Elapsed time from maternal BM correlated positively with concentrations of cytokines IL-6 and IL-10 on day 1. Conclusions: In VLBW infants, antenatal BM associated with transient immunodepression in a time-dependent manner. Suppression of both anti- and proinflammatory cytokines occurred. These effects may lead to an increased risk for later infections.

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Section: Discussionmentioning

confidence: 56%

Antenatal Betamethasone Associates with Transient Immunodepression in Very Low Birth Weight Infants

et al. 2013

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“…For example, mHLA-DR expression has been shown to be positively and negatively regulated by cytokines such as IFN-γ and IL-10, as well as by corticoids and catecholamines (83)(84)(85)(86). There is general consensus that diminished mHLA-DR expression may be a reliable marker for immunosuppression in critically ill patients (47,87,88).…”

Section: Antigen-presenting Cells: Monocytesmentioning

confidence: 99%

“…Therefore, multicenter clinical trials need to be designed with appropriate numbers of patients prospectively selected on the basis of well-defined criteria and ultimately classified on the basis of well-defined outcomes (87). A prerequisite for all centers performing mHLA-DR measurements should also be the standardization of the different protocols.…”

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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“…Multiple studies have demonstrated clearly that following either trauma or sepsis, monocytes have diminished capacity for both these responses. Specifically, they secrete fewer cytokines when stimulated and down-regulate expression of HLA receptors 24–30. Monocytes from septic patients who had decreased mHLA-DR produced low amounts of TNF-α and IL-1 in response to bacterial challenges 31.…”

Section: Antigen-presenting Cellsmentioning

confidence: 99%

“…A larger number of studies, however, have focused on monocytes and their apparent down-regulation of HLA receptors as a biomarker 24,25,27,28,60–65. In 1995, Asadulla and colleagues24 studied 57 neurosurgical patients and found that HLA-DR expression was lower in 14 patients who developed infection, compared with patients who had an uncomplicated postoperative course ( P < .0001).…”

Section: Clinical Significance Of Understanding Compensatoryanti-inflmentioning

confidence: 99%

The Compensatory Anti-inflammatory Response Syndrome (CARS) in Critically Ill Patients

Ward

Casserly

Ayala

2008

Clinics in Chest Medicine

337

248

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Like the systemic inflammatory response syndrome (SIRS), the compensatory anti-inflammatory response syndrome (CARS) is a complex pattern of immunologic responses to severe infection or injury. The difference is that while SIRS is a proinflammatory response tasked with killing infectious organisms through activation of the immune system, CARS is a global deactivation of the immune system tasked with restoring homeostasis. Much research now suggests that the timing and relative magnitude of this response have a profound impact on patient outcomes.

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Is the measurement of monocytes HLA-DR expression useful in patients with sepsis?

Cited by 24 publications

References 20 publications

Antenatal Betamethasone Associates with Transient Immunodepression in Very Low Birth Weight Infants

Antenatal Betamethasone Associates with Transient Immunodepression in Very Low Birth Weight Infants

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

The Compensatory Anti-inflammatory Response Syndrome (CARS) in Critically Ill Patients

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