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Updated: Aug 4, 2025
Characterization of Human Monocyte Subsets by Whole Blood Flow Cytometry Analysis
Published on: October 17, 2018
The Comparison of Monocyte Human Leukocyte Antigen-D-Related (mHLA-DR) Expression Levels Between Corona Virus Disease
Musholli Himmatun Nabilah1, Puspa Wardhani, Aryati Aryati
11. Laboratory Medicine Study Interest, Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia 2. Department of Medical Laboratory Technology, Health Polytechnique, Ministry of Health Republic Indonesia Surabaya, East Java, Indonesia. mushollihimmatun@gmail.com.
Insights
COVID-19 patients show significantly lower monocyte human leukocyte antigen-DR (mHLA-DR) expression compared to healthy individuals. This reduced mHLA-DR indicates a state of immunosuppression in COVID-19, particularly severe cases.
Area of Science:
- Immunology
- Virology
- Medical Diagnostics
Background:
- SARS-CoV-2 infection can induce immune dysfunction and immunosuppression in patients.
- Monocyte human leukocyte antigen-DR (mHLA-DR) is a key marker for assessing immune suppression.
- A decrease in mHLA-DR expression signifies a weakened immune state.
Purpose of the Study:
- To compare mHLA-DR expression levels between COVID-19 patients and healthy controls.
- To investigate the correlation between SARS-CoV-2 infection and immune system dysregulation.
- To establish mHLA-DR as a potential indicator of immunosuppression in COVID-19.
Main Methods:
- An observational, cross-sectional study design was employed.
- mHLA-DR expression was measured in EDTA blood samples from 34 COVID-19 patients and 15 healthy subjects.
- Flow cytometry (BD FACSLyricTM) and Quantibrite phycoerythrin beads were used for mHLA-DR quantification (AB/C units).
Main Results:
- COVID-19 patients exhibited lower mHLA-DR expression (21,201 AB/C) compared to healthy subjects (43,161 AB/C).
- A significant difference in mHLA-DR expression was observed between the two groups (p = 0.010).
- Severe to critical COVID-19 cases showed the lowest mHLA-DR levels (7,496 AB/C), falling below the reference range.
Conclusions:
- COVID-19 patients demonstrate significantly reduced mHLA-DR expression compared to healthy individuals.
- Decreased mHLA-DR levels are indicative of immunosuppression in COVID-19 patients.
- Severe COVID-19 is associated with mHLA-DR expression below the normal reference range, confirming profound immunosuppression.
Background:
SARS-CoV-2 can trigger a dysfunctional immune response in COVID-19 patients and lead to immunosuppression. HLA-DR molecule expressed on the surface of monocytes, known as mHLA-DR, has been widely used as a reliable marker of immunosuppression. Downregulation of mHLA-DR reflects an immunosuppressed state. This study aimed to compare the expression level of mHLA-DR between COVID-19 patients and healthy subjects concerning immune system dysregulation that can be triggered by SARS-CoV-2 and lead to immunosuppression.
Methods:
This was an analytic observational study with a cross-sectional design that measured the mHLA-DR expression in EDTA blood samples from 34 COVID-19 patients and 15 healthy subjects using the BD FACSLyricTM Flow Cytometry System. The mHLA-DR examination results were expressed in AB/C (antibodies bound per cell) that were quantified using a standard curve constructed with Quantibrite phycoerythrin beads (BD Biosciences).
Results:
Expression of mHLA-DR in COVID-19 patients (n = 34) were 21,201 [2,646-92,384] AB/C, with 40,543.5 [9,797-92,384] AB/C mild cases (n = 22), 21,201 [9,831-31,930] AB/C moderate cases (n = 6), and 7,496 [2,646-13,674] AB/C severe to critical cases (n= 6). Expression of mHLA-DR in healthy subjects (n = 15) was 43,161 [25,147-89,846] AB/C. Based on the Mann-Whitney U test, the mHLA-DR expression in COVID-19 patients significantly differed from the mHLA-DR expression in healthy subjects (p = 0.010).
Conclusion:
The level of mHLA-DR expression in COVID-19 patients was lower and significantly different from healthy subjects. Moreover, immunosuppression could be indicated by the decrease of mHLA-DR expression, which was below the reference range found in severe to critically ill COVID-19 patients.
