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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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