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HLA-DR expression and soluble HLA-DR levels in septic patients after trauma
M Ditschkowski1, E Kreuzfelder, V Rebmann
1Institute of Immunology, University Hospital of Essen, Germany.
Objective:
To determine if cellular and soluble HLA-DR molecules may be relevant in severely injured patients for the development of gram-positive or gram-negative sepsis.
Summary Background Data:
HLA-DR molecules play a central role in the specific immune response to infection. The reduced HLA-DR expression on monocytes is considered to correlate with infectious complications and the development of sepsis. Data on the role of HLA-DR expression on T cells and soluble HLA-DR molecules are rare.
Methods:
HLA-DR expression on monocytes and T cells was measured by flow cytometry. Plasma levels of soluble HLA-DR were studied by enzyme-linked immunosorbent assay.
Results:
HLA-DR expression on circulating T cells, calculated as mean fluorescence intensity in channels, was reduced at day 1 after admission in 20 patients with subsequent severe sepsis compared with 46 patients without sepsis. The septic patients immediately after trauma had significantly lower soluble HLA-DR plasma levels than the nonseptic patients. At day 2 after admission, HLA-DR expression on monocytes was significantly lower in the severe sepsis group than in the patients without sepsis, and lasted until day 14 after injury.
Conclusions:
In severely injured patients, decreased levels of cellular and soluble HLA-DR appear as early indicators of an immune deviation associated with the development of severe sepsis. Moreover, immune alterations of different cell types may promote distinct kinds of septicemia.
Insights
In severely injured patients, reduced Human Leukocyte Antigen - antigen D Related (HLA-DR) on T cells and in plasma are early sepsis indicators. These immune deviations may predict sepsis development and distinct septicemia types.
Area of Science:
- Immunology
- Trauma research
- Sepsis pathogenesis
Background:
- Human Leukocyte Antigen - antigen D Related (HLA-DR) molecules are crucial for specific immune responses to infections.
- Reduced monocyte HLA-DR expression is linked to infectious complications and sepsis development.
- Limited data exists on HLA-DR expression on T cells and soluble HLA-DR molecules in sepsis.
Purpose of the Study:
- To investigate the role of cellular and soluble HLA-DR molecules in the development of gram-positive or gram-negative sepsis in severely injured patients.
- To identify potential early biomarkers for sepsis in trauma patients.
Main Methods:
- Flow cytometry was used to measure HLA-DR expression on monocytes and T cells.
- Enzyme-linked immunosorbent assay (ELISA) was employed to quantify plasma levels of soluble HLA-DR.
Main Results:
- Patients who developed severe sepsis showed reduced HLA-DR expression on circulating T cells at day 1 post-admission.
- Septic patients had significantly lower plasma levels of soluble HLA-DR immediately after trauma compared to non-septic patients.
- Monocyte HLA-DR expression was significantly lower in the severe sepsis group from day 2 to day 14 post-injury.
Conclusions:
- Decreased cellular and soluble HLA-DR levels serve as early indicators of immune deviation linked to severe sepsis development in severely injured patients.
- Distinct immune alterations in different cell types might contribute to the development of specific types of septicemia.