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Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study
Intensive care unit (ICU) patients develop an altered host immune response after severe injuries. This response may evolve towards a state of persistent immunosuppression that is associated with adverse clinical outcomes. The expression of human leukocyte antigen DR on circulating monocytes (mHLA-DR...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745266/ https://www.ncbi.nlm.nih.gov/pubmed/35011836 http://dx.doi.org/10.3390/jcm11010096 |
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author | Bidar, Frank Bodinier, Maxime Venet, Fabienne Lukaszewicz, Anne-Claire Brengel-Pesce, Karen Conti, Filippo Quemeneur, Laurence Leissner, Philippe Tan, Lionel K. Textoris, Julien Rimmelé, Thomas Monneret, Guillaume |
author_facet | Bidar, Frank Bodinier, Maxime Venet, Fabienne Lukaszewicz, Anne-Claire Brengel-Pesce, Karen Conti, Filippo Quemeneur, Laurence Leissner, Philippe Tan, Lionel K. Textoris, Julien Rimmelé, Thomas Monneret, Guillaume |
author_sort | Bidar, Frank |
collection | PubMed |
description | Intensive care unit (ICU) patients develop an altered host immune response after severe injuries. This response may evolve towards a state of persistent immunosuppression that is associated with adverse clinical outcomes. The expression of human leukocyte antigen DR on circulating monocytes (mHLA-DR) and ex vivo release of tumor necrosis factor α (TNF-α) by lipopolysaccharide-stimulated whole blood are two related biomarkers offered to characterize this phenomenon. The purpose of this study was to concomitantly evaluate the association between mHLA-DR and TNF-α release and adverse clinical outcome (i.e., death or secondary infection) after severe trauma, sepsis or surgery in a cohort of 353 ICU patients. mHLA-DR and TNF-α release was similarly and significantly reduced in patients whatever the type of injury. Persistent decreases in both markers at days 5–7 (post-admission) were significantly associated with adverse outcomes. Overall, mHLA-DR (measured by flow cytometry) appears to be a more robust and standardized parameter. Each marker can be used individually as a surrogate of immunosuppression, depending on center facilities. Combining these two parameters could be of interest to identify the most immunosuppressed patients presenting with a high risk of worsening. This last aspect deserves further exploration. |
format | Online Article Text |
id | pubmed-8745266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87452662022-01-11 Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study Bidar, Frank Bodinier, Maxime Venet, Fabienne Lukaszewicz, Anne-Claire Brengel-Pesce, Karen Conti, Filippo Quemeneur, Laurence Leissner, Philippe Tan, Lionel K. Textoris, Julien Rimmelé, Thomas Monneret, Guillaume J Clin Med Article Intensive care unit (ICU) patients develop an altered host immune response after severe injuries. This response may evolve towards a state of persistent immunosuppression that is associated with adverse clinical outcomes. The expression of human leukocyte antigen DR on circulating monocytes (mHLA-DR) and ex vivo release of tumor necrosis factor α (TNF-α) by lipopolysaccharide-stimulated whole blood are two related biomarkers offered to characterize this phenomenon. The purpose of this study was to concomitantly evaluate the association between mHLA-DR and TNF-α release and adverse clinical outcome (i.e., death or secondary infection) after severe trauma, sepsis or surgery in a cohort of 353 ICU patients. mHLA-DR and TNF-α release was similarly and significantly reduced in patients whatever the type of injury. Persistent decreases in both markers at days 5–7 (post-admission) were significantly associated with adverse outcomes. Overall, mHLA-DR (measured by flow cytometry) appears to be a more robust and standardized parameter. Each marker can be used individually as a surrogate of immunosuppression, depending on center facilities. Combining these two parameters could be of interest to identify the most immunosuppressed patients presenting with a high risk of worsening. This last aspect deserves further exploration. MDPI 2021-12-24 /pmc/articles/PMC8745266/ /pubmed/35011836 http://dx.doi.org/10.3390/jcm11010096 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bidar, Frank Bodinier, Maxime Venet, Fabienne Lukaszewicz, Anne-Claire Brengel-Pesce, Karen Conti, Filippo Quemeneur, Laurence Leissner, Philippe Tan, Lionel K. Textoris, Julien Rimmelé, Thomas Monneret, Guillaume Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study |
title | Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study |
title_full | Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study |
title_fullStr | Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study |
title_full_unstemmed | Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study |
title_short | Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries—Insights from the REALISM Study |
title_sort | concomitant assessment of monocyte hla-dr expression and ex vivo tnf-α release as markers of adverse outcome after various injuries—insights from the realism study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745266/ https://www.ncbi.nlm.nih.gov/pubmed/35011836 http://dx.doi.org/10.3390/jcm11010096 |
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