Monocyte HLA-DR expression as predictor of poor outcome in neonates with late onset neonatal sepsis

Genel, Ferah; Atlıhan, Füsun; Özsu, Elif; Özbek, Erhan

doi:10.1016/j.jinf.2009.12.004

Cited by 53 publications

(47 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The observed decrease in the course of sepsis or bacteremia of HLA-DR expression on CD14+ monocytes identifies a group of immunosuppressed pediatric patients and young adults after HSCT with an additional risk factor. For infectious complications, the degree of reduction of the HLA-DR expression on monocytes, as defined by the MFI HLA-DR expression on monocytes, serves as a prognostic indicator for the severity of sepsis [12,[21][22][23]. In burn victims with and without sepsis, this reduction was shown to be a useful parameter for monitoring the immune function [24].…”

Section: Discussionmentioning

confidence: 99%

Human leukocyte antigen DR surface expression on CD14+ monocytes during adverse events after hematopoietic stem cell transplantation

et al. 2014

View full text Add to dashboard Cite

The human leukocyte antigen DR surface expression on CD14+ monocytes reflects the degree to which these cells have been activated. Given the central role monocytes and macrophages play in the immune system, a decreased human leukocyte antigen DR expression on CD14+ monocytes results in a hallmark of altered immune status during systemic inflammatory response syndrome. We hypothesize that human leukocyte antigen DR expression might be similarly altered after hematopoietic stem cell transplantation and during post-transplant complications. Using flow cytometry, this study investigates the human leukocyte antigen DR surface expression of CD14+ monocytes in 30 pediatric and young adult patients up to 1 year after hematopoietic stem cell transplantation. Normal values were derived from a control group of healthy children, adolescents, and young adults. Human leukocyte antigen DR expression decreased significantly prior and during bacterial infection or sepsis. By contrast, human leukocyte antigen DR expression levels were elevated before and at the time of viremia. Human leukocyte antigen DR expression was also elevated during acute graft-versus-host disease. In contrast, the expression was reduced when patients had hepatic veno-occlusive disease. A significant decrease of human leukocyte antigen DR expression was associated with a relapse of the underlying disease and before death. Human leukocyte antigen DR expression on CD14+ monocytes appears to be a promising parameter that might allow identification of patients at risk after hematopoietic stem cell transplantation.

show abstract

Section: Discussionmentioning

confidence: 99%

Human leukocyte antigen DR surface expression on CD14+ monocytes during adverse events after hematopoietic stem cell transplantation

et al. 2014

View full text Add to dashboard Cite

show abstract

“…24 Meisel et al 20 and Schefold et al 25 demonstrated that awareness of the levels of mHLA-DR may help in guiding immunomodulatory therapy, shortening mechanical ventilation time and the duration of hospital stay. In recent years, several studies have shown that mHLA-DR is a valuable factor that can predict the outcomes of subjects with sepsis, severe pancreatitis, non-small cell lung cancers, cirrhosis, and secondary infections [3][4][5][6][7][8] ; some studies concluded otherwise, as the investigators suggested that mHLA-DR is not an independent factor that affects the outcomes of subjects and pointed out the limitations of flow cytometer examinations. [9][10][11] The immune system plays an important role in the development and progression of pneumonia, and mHLA-DR is a widely accepted biomarker that can reflect the immune functions.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies over the past few years have demonstrated that monocyte human leukocyte antigen-DR (mHLA-DR) is a potential biomarker in predicting the outcomes of subjects with certain diseases (including sepsis, severe pancreatitis, non-small cell lung cancer, cirrhosis, and secondary infection), [3][4][5][6][7][8] although some studies have contrasting results. [9][10][11] The immune system plays an important role in the development, progression, and prognosis of pneumonia, 12 which suggests that this widely accepted immune function-related biomarker may predict outcomes in patients with severe pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Predicting the Outcomes of Subjects With Severe Community-Acquired Pneumonia Using Monocyte Human Leukocyte Antigen-DR

Zhuang

Wang

et al. 2015

Respir Care

View full text Add to dashboard Cite

BACKGROUND:The objective was to study the level of monocyte-human leukocyte antigen-DR (mHLA-DR), an immune function-related biomarker, at 24 h after admission, to predict the outcomes of subjects with severe pneumonia. METHODS: Subjects with severe community-acquired pneumonia (n ‫؍‬ 102) were included in the study. Blood samples were collected from each subject 24 h after admission. Data regarding age, sex, P aO 2 /F IO 2 , comorbidities, occurrence of altered mental status, bacteremia, septic shock, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score within the first 24 h; the highest temperature within 24 h after admission; mechanical ventilation usage; timing of antibiotic therapy; ICU stay; and 28-d survival were collected. Expression of mHLA-DR was measured by flow cytometry. RESULTS: APACHE II score and SOFA score were significantly higher (P < .001), whereas the mHLA-DR expression was significantly lower (P < .001) in the non-survivors than in the survivors. The outcomes at day 28 after admission were significantly associated with the APACHE II score (P ‫؍‬ .002, odds ratio [OR] ‫؍‬ 1.27, 95% CI 1.10 -1.48), the SOFA score (P ‫؍‬ .003, OR ‫؍‬ 1.52, 95% CI 1.15-2.00), and mHLA-DR level (P ‫؍‬ .01, OR ‫؍‬ 0.91, 95% CI 0.85-0.98), as shown by logistic regression. The area under the receiver operating characteristic curve was 0.877 (95% CI 0.81-0.94, P < .001), 0.862 (95% CI 0.79 -0.93, P < .001), and 0.781 (95% CI 0.69 -0.87, P < .001) for APACHE II score, SOFA score, and the mHLA-DR expression, respectively. The optimal threshold for mHLA-DR level was 27.2%. Kaplan-Meier survival analysis showed that subjects with mHLA-DR > 27.2% had significantly better outcomes compared with < 27.2% level (P < .001, log rank test, hazard ratio ‫؍‬ 0.963, 95% CI 0.94 -0.99). CONCLUSIONS: mHLA-DR may be a reliable biomarker that can predict the outcomes of patients with severe community-acquired pneumonia, and 27.2% may be the cut-off value to predict the outcomes.

show abstract

“…The literature investigating the HLA system in sepsis, however, almost exclusively explores HLA-DR membrane expression. Indeed, numerous publications implicate low HLA-DR membrane expression as a predictor of sepsis development (21) and poor septic outcome, (22,23) and it has become the most reliable ICU-acquired immunosuppression marker. (24,25) In our study, however, complete genetic screening of the HLA-DR locus was unable to find any allele more prevalent in the septic population.…”

Section: Discussionmentioning

confidence: 99%

HLA-A*31 as a marker of genetic susceptibility to sepsis

Silva

Filho

Finger³

et al. 2013

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

ObjectiveThe HLA haplotype has been associated with many autoimmune diseases, but no associations have been described in sepsis. This study aims to investigate the HLA system as a possible marker of genetic sepsis susceptibility.MethodsThis is a prospective cohort study including patients admitted to an intensive care unit and healthy controls from a list of renal transplant donors. Patients with less 18 years of age; pregnant or HIV positive patients; those with metastatic malignancies or receiving chemotherapy; or with advanced liver disease; or with end-of-life conditions were excluded. The DNA was extracted from the whole blood and HLA haplotypes determined using MiliPlex® technology.ResultsFrom October 2010 to October 2012, 1,121 patients were included (1,078 kidney donors, 20 patients admitted with severe sepsis and 23 with septic shock). HLA-A*31 positive subjects had increased risk of developing sepsis (OR 2.36, 95%CI 1.26-5.35). Considering a p value <0.01, no other significant association was identified.ConclusionHLA-A*31 expression is associated to risk of developing sepsis.

show abstract

Monocyte HLA-DR expression as predictor of poor outcome in neonates with late onset neonatal sepsis

Cited by 53 publications

References 29 publications

Human leukocyte antigen DR surface expression on CD14+ monocytes during adverse events after hematopoietic stem cell transplantation

Human leukocyte antigen DR surface expression on CD14+ monocytes during adverse events after hematopoietic stem cell transplantation

Predicting the Outcomes of Subjects With Severe Community-Acquired Pneumonia Using Monocyte Human Leukocyte Antigen-DR

HLA-A*31 as a marker of genetic susceptibility to sepsis

Contact Info

Product

Resources

About