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Critical Care
Published in: Critical Care 1/2014

Open Access 01-02-2014 | Commentary

Monocyte HLA-DR in sepsis: shall we stop following the flow?

Authors: Guillaume Monneret, Fabienne Venet

Published in: Critical Care | Issue 1/2014

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Abstract

The best marker for the monitoring of immune alterations in critically ill patients (sepsis, trauma, pancreatitis, surgery, burns) so far remains decreased HLA-DR expression on monocytes measured by flow cytometry as it regularly provides valuable information in terms of mortality prediction or evaluation of risk for secondary infections. As shown by Cajander and colleagues in a recent issue of Critical Care, some promising tools-based molecular biology may circumvent some drawbacks related to flow cytometry. Herein, issues and perspectives about this alternative are discussed.
Literature
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Cajander S, Bäckman A, Tina E, Strålin K, Söderquist B, Källman J: Preliminary results in quantitation of HLA-DRA by real-time PCR: a promising approach to identify immunosuppression in sepsis. Crit Care 2013, 17: R223. 10.1186/cc13046PubMedCentralCrossRefPubMed
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Hotchkiss RS, Monneret G, Payen D: Immunosuppression in sepsis: a novel understanding of the disorder and a new therapeutic approach. Lancet Infect Dis 2013, 13: 260-268. 10.1016/S1473-3099(13)70001-XPubMedCentralCrossRefPubMed
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Venet F, Lukaszewicz AC, Payen D, Hotchkiss R, Monneret G: Monitoring the immune response in sepsis: a rational approach to administration of immunoadjuvant therapies. Curr Opin Immunol 2013, 25: 477-483. 10.1016/j.coi.2013.05.006PubMedCentralCrossRefPubMed
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Cazalis M, Friggeri A, Cavé L, Demaret J, Barbalat V, Cerrato E, Lepape A, Pachot A, Monneret G, Venet F: Decreased HLA-DR antigen-associated invariant chain (CD74) mRNA expression predicts mortality after septic shock. Crit Care 2013, 17: R287. 10.1186/cc13150PubMedCentralCrossRefPubMed
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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.2005.052639CrossRefPubMed
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Pachot A, Monneret G, Brion A, Venet F, Bohe J, Bienvenu J, Mougin B, Lepape A: Messenger RNA expression of major histocompatibility complex class II genes in whole blood from septic shock patients. Crit Care Med 2005, 33: 31-38. discussion 236–237 10.1097/01.CCM.0000150958.20209.A3CrossRefPubMed
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Le Tulzo Y, Pangault C, Amiot L, Guilloux V, Tribut O, Arvieux C, Camus C, Fauchet R, Thomas R, Drenou B: Monocyte human leukocyte antigen-DR transcriptional downregulation by cortisol during septic shock. Am J Respir Crit Care Med 2004, 169: 1144-1151. 10.1164/rccm.200309-1329OCCrossRefPubMed
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Monneret G, Elmenkouri N, Bohe J, Debard AL, Gutowski MC, Bienvenu J, Lepape A: Analytical requirements for measuring monocytic human lymphocyte antigen DR by flow cytometry: application to the monitoring of patients with septic shock. Clin Chem 2002, 48: 1589-1592.PubMed
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Demaret J, Walencik A, Jacob MC, Timsit JF, Venet F, Lepape A, Monneret G: Inter-laboratory assessment of flow cytometric monocyte HLA-DR expression in clinical samples. Cytometry B Clin Cytom 2013, 84: 59-62.CrossRefPubMed
Metadata
Title
Monocyte HLA-DR in sepsis: shall we stop following the flow?
Authors
Guillaume Monneret
Fabienne Venet
Publication date
01-02-2014
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2014
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13179

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