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

Autor: Frank Bidar, Maxime Bodinier, Fabienne Venet, Anne-Claire Lukaszewicz, Karen Brengel-Pesce, Filippo Conti, Laurence Quemeneur, Philippe Leissner, Lionel K. Tan, Julien Textoris, Thomas Rimmelé, Guillaume Monneret, on behalf of the Realism Study Group
Přispěvatelé: Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Sanofi Pasteur [Marcy-l'Étoile, France], BIOASTER Microbiology Technology Institute [Lyon], GSK House [Middlesex, London]
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Clinical Medicine; Volume 11; Issue 1; Pages: 96
Journal of Clinical Medicine, Vol 11, Iss 96, p 96 (2022)
Journal of Clinical Medicine
Journal of Clinical Medicine, 2022, 11 (1), pp.96. ⟨10.3390/jcm11010096⟩
ISSN: 2077-0383
DOI: 10.3390/jcm11010096
Popis: 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.
Databáze: OpenAIRE
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