PMID- 10414692
OWN - NLM
STAT- MEDLINE
DCOM- 19990809
LR  - 20201209
IS  - 0002-9610 (Print)
IS  - 0002-9610 (Linking)
VI  - 177
IP  - 6
DP  - 1999 Jun
TI  - Monocyte human leukocyte antigen-DR expression correlates with intrapulmonary 
      shunting after major trauma.
PG  - 454-9
AB  - BACKGROUND: Severe injury is often complicated by the development of sepsis and 
      the adult respiratory distress syndrome. Since the outcome from severe injury 
      also correlates with changes in monocyte human leukocyte antigen (HLA)-DR 
      expression in such patients, the present study aimed to determine whether or not 
      there was a relationship between monocyte HLA-DR expression and indicators of 
      early pulmonary dysfunction. METHODS: Monocyte HLA-DR expression and serum 
      interleukin (IL)-6 were measured on admission and then again on days 1, 3, 5, and 
      7 after major injury in 29 patients admitted for the management of trauma with an 
      injury severity score of 9 or more. Noninvasive intrapulmonary shunt measurement 
      was also performed in all these patients within 6 hours of emergency surgery in 
      all patients. RESULTS: Monocyte HLA-DR followed the characteristic suppression 
      followed by recovery in those who followed an uncomplicated course but 
      progressively declined in those who suffered septic complications. The degree of 
      intrapulmonary shunting observed 6 hours after injury in the patients who 
      developed sepsis was significantly higher than that in the uncomplicated group. 
      Peak monocyte HLA-DR expression during the recovery phase correlated inversely 
      with the degree of intrapulmonary shunting. CONCLUSIONS: The degree of 
      intrapulmonary shunting observed following severe trauma correlates with the 
      failure of circulating monocytes to re-express HLA-DR antigen, and this may 
      provide some insights into the early events that result in the adult respiratory 
      distress syndrome after major injury.
FAU - Giannoudis, P V
AU  - Giannoudis PV
AD  - Academic Unit of Orthopedics and Trauma, St. James's University Hospital, Leeds, 
      United Kingdom.
FAU - Smith, R M
AU  - Smith RM
FAU - Windsor, A C
AU  - Windsor AC
FAU - Bellamy, M C
AU  - Bellamy MC
FAU - Guillou, P J
AU  - Guillou PJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Surg
JT  - American journal of surgery
JID - 0370473
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Interleukin-6)
SB  - IM
MH  - Adult
MH  - Female
MH  - HLA-DR Antigens/*metabolism
MH  - Humans
MH  - Interleukin-6/*blood
MH  - Male
MH  - Monocytes/metabolism
MH  - Predictive Value of Tests
MH  - *Pulmonary Circulation
MH  - Respiratory Distress Syndrome/*etiology/immunology
MH  - Systemic Inflammatory Response Syndrome/*etiology/immunology
MH  - Trauma Severity Indices
EDAT- 1999/07/22 00:00
MHDA- 1999/07/22 00:01
CRDT- 1999/07/22 00:00
PHST- 1999/07/22 00:00 [pubmed]
PHST- 1999/07/22 00:01 [medline]
PHST- 1999/07/22 00:00 [entrez]
AID - S0002961099000999 [pii]
AID - 10.1016/s0002-9610(99)00099-9 [doi]
PST - ppublish
SO  - Am J Surg. 1999 Jun;177(6):454-9. doi: 10.1016/s0002-9610(99)00099-9.