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Published in: Critical Care 5/2011

01-10-2011 | Commentary

A dynamic view of mHLA-DR expression in management of severe septic patients

Authors: Guillaume Monneret, Alain Lepape, Fabienne Venet

Published in: Critical Care | Issue 5/2011

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Abstract

Increasing evidence suggests that the secondary phase of sepsis (that is, after the first proinflammatory hours) is characterized by the occurrence of a systemic failure of the immune system. In the most immunodepressed patients, therapies could be used to restore normal immune functions. However, biomarkers need to be developed to beforehand specifically identify these patients. Of these biomarkers, diminished monocyte HLA-DR expression has rapidly become the most popular. Herein, novel perspectives regarding monocyte HLA-DR assessed as a dynamic parameter in septic patients will be discussed in the context of a recently published study investigating daily evolution of monocyte HLA-DR with regard to 28 day-mortality after severe sepsis.
Literature
1.
go back to reference Wu J-F, Jie Ma JC, Ou-Yang B, Chen M-Y, Li LF, Liu Y-J, Lin A-h, Guan X-D: Changes of monocyte human leukocyte antigen-DR expression as a reliable predictor of mortality in severe sepsis. Crit Care. 2011, 15: R220-10.1186/cc10457.PubMedCentralCrossRefPubMed Wu J-F, Jie Ma JC, Ou-Yang B, Chen M-Y, Li LF, Liu Y-J, Lin A-h, Guan X-D: Changes of monocyte human leukocyte antigen-DR expression as a reliable predictor of mortality in severe sepsis. Crit Care. 2011, 15: R220-10.1186/cc10457.PubMedCentralCrossRefPubMed
2.
go back to reference Hotchkiss RS, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003, 348: 138-150. 10.1056/NEJMra021333.CrossRefPubMed Hotchkiss RS, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003, 348: 138-150. 10.1056/NEJMra021333.CrossRefPubMed
3.
go back to reference Monneret G, Venet F, Pachot A, Lepape A: Monitoring immune dysfunctions in the septic patient: a new skin for the old ceremony. Mol Med. 2008, 14: 64-78.PubMedCentralCrossRefPubMed Monneret G, Venet F, Pachot A, Lepape A: Monitoring immune dysfunctions in the septic patient: a new skin for the old ceremony. Mol Med. 2008, 14: 64-78.PubMedCentralCrossRefPubMed
4.
go back to reference Monneret G, Venet F, Kullberg BJ, Netea MG: ICU-acquired immunosuppression and the risk for secondary fungal infections. Med Mycol. 2011, 49 (Suppl 1): S17-S23.CrossRefPubMed Monneret G, Venet F, Kullberg BJ, Netea MG: ICU-acquired immunosuppression and the risk for secondary fungal infections. Med Mycol. 2011, 49 (Suppl 1): S17-S23.CrossRefPubMed
5.
go back to reference Kalil AC, Florescu DF: Prevalence and mortality associated with cytomegalovirus infection in nonimmunosuppressed patients in the intensive care unit. Crit Care Med. 2009, 37: 2350-2358. 10.1097/CCM.0b013e3181a3aa43.CrossRefPubMed Kalil AC, Florescu DF: Prevalence and mortality associated with cytomegalovirus infection in nonimmunosuppressed patients in the intensive care unit. Crit Care Med. 2009, 37: 2350-2358. 10.1097/CCM.0b013e3181a3aa43.CrossRefPubMed
6.
go back to reference Pugin J: Immunostimulation is a rational therapeutic strategy in sepsis. Novartis Found Symp. 2007, 280: 21-27; discussion 27-36, 160-164.CrossRefPubMed Pugin J: Immunostimulation is a rational therapeutic strategy in sepsis. Novartis Found Symp. 2007, 280: 21-27; discussion 27-36, 160-164.CrossRefPubMed
7.
go back to reference Meisel C, Schefold JC, Pschowski R, Baumann T, Hetzger K, Gregor J, Weber-Carstens S, Hasper D, Keh D, Zuckermann H, Reinke P, Volk HD: GM-CSF to reverse sepsis-associated immunosuppression: a double-blind randomized placebo-controlled multicenter trial. Am J Respir Crit Care Med. 2009, 180: 640-648. 10.1164/rccm.200903-0363OC.CrossRefPubMed Meisel C, Schefold JC, Pschowski R, Baumann T, Hetzger K, Gregor J, Weber-Carstens S, Hasper D, Keh D, Zuckermann H, Reinke P, Volk HD: GM-CSF to reverse sepsis-associated immunosuppression: a double-blind randomized placebo-controlled multicenter trial. Am J Respir Crit Care Med. 2009, 180: 640-648. 10.1164/rccm.200903-0363OC.CrossRefPubMed
8.
go back to reference Lukaszewicz AC, Grienay M, Resche-Rigon M, Pirracchio R, Faivre V, Boval B, Payen D: Monocytic HLA-DR expression in intensive care patients: interest for prognosis and secondary infection prediction. Crit Care Med. 2009, 37: 2746-2752. 10.1097/CCM.0b013e3181ab858a.CrossRefPubMed Lukaszewicz AC, Grienay M, Resche-Rigon M, Pirracchio R, Faivre V, Boval B, Payen D: Monocytic HLA-DR expression in intensive care patients: interest for prognosis and secondary infection prediction. Crit Care Med. 2009, 37: 2746-2752. 10.1097/CCM.0b013e3181ab858a.CrossRefPubMed
9.
go back to reference Cheron A, Floccard B, Allaouchiche B, Guignant C, Poitevin F, Malcus C, Crozon J, Faure A, Guillaume C, Marcotte G, Vulliez A, Monneuse O, Monneret G: Lack of recovery in monocyte human leukocyte antigen-DR expression is independently associated with the development of sepsis after major trauma. Crit Care. 2010, 14: R208-10.1186/cc9331.PubMedCentralCrossRefPubMed Cheron A, Floccard B, Allaouchiche B, Guignant C, Poitevin F, Malcus C, Crozon J, Faure A, Guillaume C, Marcotte G, Vulliez A, Monneuse O, Monneret G: Lack of recovery in monocyte human leukocyte antigen-DR expression is independently associated with the development of sepsis after major trauma. Crit Care. 2010, 14: R208-10.1186/cc9331.PubMedCentralCrossRefPubMed
10.
go back to reference Docke WD, Hoflich C, Davis KA, Rottgers K, Meisel C, Kiefer P, Weber SU, Hedwig-Geissing M, Kreuzfelder E, Tschentscher P, Nebe T, Engel A, Monneret G, Spittler A, Schmolke K, Reinke P, Volk HD, Kunz D: Monitoring temporary immunodepression by flow cytometric measurement of monocytic HLA-DR expression: a multicenter standardized study. Clin Chem. 2005, 51: 2341-2347. 10.1373/clinchem.2005.052639.CrossRefPubMed Docke WD, Hoflich C, Davis KA, Rottgers K, Meisel C, Kiefer P, Weber SU, Hedwig-Geissing M, Kreuzfelder E, Tschentscher P, Nebe T, Engel A, Monneret G, Spittler A, Schmolke K, Reinke P, Volk HD, Kunz D: Monitoring temporary immunodepression by flow cytometric measurement of monocytic HLA-DR expression: a multicenter standardized study. Clin Chem. 2005, 51: 2341-2347. 10.1373/clinchem.2005.052639.CrossRefPubMed
11.
go back to reference Venet F, Lepape A, Monneret G: Clinical review: flow cytometry perspectives in the ICU: from diagnosis of infection to monitoring of injury-induced immune dysfunctions. Crit Care. 2011, 15: 231-10.1186/cc10333.PubMedCentralCrossRefPubMed Venet F, Lepape A, Monneret G: Clinical review: flow cytometry perspectives in the ICU: from diagnosis of infection to monitoring of injury-induced immune dysfunctions. Crit Care. 2011, 15: 231-10.1186/cc10333.PubMedCentralCrossRefPubMed
Metadata
Title
A dynamic view of mHLA-DR expression in management of severe septic patients
Authors
Guillaume Monneret
Alain Lepape
Fabienne Venet
Publication date
01-10-2011
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2011
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc10452

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