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HLA-DR antigen expression on peripheral blood monocytes correlates with surgical infection
W G Cheadle1, M J Hershman, S R Wellhausen
1Department of Surgery, University of Louisville School of Medicine, Kentucky.
Abstract:
Monocyte human leukocyte antigen-DR (HLA-DR) expression has correlated closely with clinical outcome in severely injured patients at high risk for infection. Monocytes from 77 asymptomatic volunteers expressed HLA-DR antigen with minimal variability in respect to age, gender, race, time of day or year, or serum alcohol level. Patients who developed infection after elective laparotomy had a significantly lower mean percentage of monocytes expressing HLA-DR antigen and a lower mean fluorescent intensity than uninfected patients (p less than 0.05). Severely infected nonsurgical patients had significantly lower values than normal volunteers (p less than 0.01), and the mean fluorescent intensity of those who died from infection was significantly lower than that of those who survived (p less than 0.05). Patients on immunosuppressive regimens after renal transplantation had levels of HLA-DR expression similar to those of the volunteers. Monocyte HLA-DR expression was found to be a reliable marker of clinical infection and showed remarkable reproducibility within the normal uninfected study population.
Insights
Monocyte human leukocyte antigen-DR (HLA-DR) expression is a reliable indicator of clinical infection in patients. Lower HLA-DR levels correlate with increased infection severity and poorer outcomes, highlighting its prognostic value.
Area of Science:
- Immunology
- Clinical Medicine
- Biomarker Discovery
Background:
- Monocyte human leukocyte antigen-DR (HLA-DR) expression is linked to patient outcomes in severe injury.
- Assessing HLA-DR expression variability in healthy individuals is crucial for establishing baseline values.
Purpose of the Study:
- To evaluate monocyte HLA-DR expression as a reliable diagnostic marker for clinical infection.
- To correlate monocyte HLA-DR levels with infection severity and patient prognosis.
Main Methods:
- Flow cytometry was used to quantify monocyte HLA-DR expression (percentage and mean fluorescent intensity).
- Comparison of HLA-DR levels between asymptomatic volunteers, infected surgical patients, infected nonsurgical patients, and transplant recipients.
Main Results:
- Infected patients exhibited significantly lower monocyte HLA-DR expression compared to uninfected individuals.
- Severely infected patients showed reduced HLA-DR levels versus healthy volunteers.
- Lower mean fluorescent intensity of HLA-DR correlated with increased mortality in infected patients.
Conclusions:
- Monocyte HLA-DR expression serves as a reproducible and reliable biomarker for detecting clinical infection.
- Diminished HLA-DR expression on monocytes is associated with infection severity and predicts patient outcomes.