PMID- 15249240
OWN - NLM
STAT- MEDLINE
DCOM- 20040810
LR  - 20181130
IS  - 0002-9610 (Print)
IS  - 0002-9610 (Linking)
VI  - 188
IP  - 2
DP  - 2004 Aug
TI  - Modulation of human leukocyte antigen-DR on monocytes and CD16 on granulocytes in 
      patients with septic shock using hemoperfusion with polymyxin B-immobilized 
      fiber.
PG  - 150-6
AB  - BACKGROUND: Hemoperfusion with PMX-F (polymyxin B covalently immobilized on 
      fibers) has been reported to be safe and effective for patients with septic 
      shock. However, the molecular mechanism of this usefulness is not yet clear. The 
      purpose of this study was to evaluate whether the expression of CD14, human 
      leukocyte antigen (HLA)-DR on monocytes, and the expression of CD16, CD11b/CD18 
      on neutrophils, are altered in septic patients according to the severity, and 
      whether PMX-F treatment affects the clinical parameters and the expression of 
      leukocyte surface antigen expression. PATIENTS AND METHODS: Thirty-four patients 
      who were taken to the National Defense Medical College hospital at emergency, and 
      who had an identified focus of infections, were enrolled in this study. The 
      patients were divided into three groups: non-systemic inflammatory response 
      syndrome [SIRS]) group, sepsis group, and septic shock group. Peripheral blood 
      samples were collected at the time of admission to our hospital. The CD14, HLA-DR 
      expression on monocytes and the CD11b/CD18, CD16 expression on granulocytes were 
      evaluated using flowcytometry, and the serum interleukin (IL)-6 and IL-10 levels 
      were measured using enzyme-linked immunosorbent assay. Treatment with a PMX-F 
      column was performed in 10 patients with septic shock. RESULTS: The HLA-DR 
      expression on monocytes and the CD16 intensity on granulocytes in patients with 
      septic shock were significantly lower than those in patients with sepsis. The 
      serum IL-6 and 10 levels in patients with septic shock were significantly higher 
      than those in patients with sepsis. The mean systolic blood pressure in patients 
      with septic shock was significantly increased after the PMX-F treatment; 
      furthermore, the HLA-DR expression on monocytes and the CD16 intensity on 
      granulocytes were significantly increased after the PMX-F treatment. The serum 
      IL-10 levels were significantly decreased after the PMX-F treatment. CONCLUSIONS: 
      We showed that the surface antigens, HLA-DR on monocytes and CD16 on 
      granulocytes, are extremely decreased in patients with septic shock, and that 
      PMX-F treatment is effective for beneficially increasing the surface antigen 
      expression on leukocytes. This therapy might be a new strategy for helping 
      patients recover from immunoparalysis in septic conditions.
FAU - Ono, Satoshi
AU  - Ono S
AD  - Department of Surgery I, National Defense Medical College, Namiki 3-2, 
      Tokorozawa, Saitama 359-8513, Japan. satoshi@me.ndmc.ac.jp
FAU - Tsujimoto, Hironori
AU  - Tsujimoto H
FAU - Matsumoto, Atsushi
AU  - Matsumoto A
FAU - Ikuta, Shin-Ichi
AU  - Ikuta S
FAU - Kinoshita, Manabu
AU  - Kinoshita M
FAU - Mochizuki, Hidetaka
AU  - Mochizuki H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Surg
JT  - American journal of surgery
JID - 0370473
RN  - 0 (CD11b Antigen)
RN  - 0 (CD18 Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Interleukin-6)
RN  - 0 (Lipopolysaccharide Receptors)
RN  - 0 (Receptors, IgG)
RN  - 130068-27-8 (Interleukin-10)
RN  - J2VZ07J96K (Polymyxin B)
SB  - IM
MH  - Aged
MH  - CD11b Antigen/*immunology
MH  - CD18 Antigens/*immunology
MH  - Female
MH  - Flow Cytometry
MH  - Granulocytes/*immunology
MH  - HLA-DR Antigens/*immunology
MH  - *Hemoperfusion
MH  - Humans
MH  - Interleukin-10/blood
MH  - Interleukin-6/blood
MH  - Lipopolysaccharide Receptors/*immunology
MH  - Male
MH  - Middle Aged
MH  - Polymyxin B
MH  - Receptors, IgG/*immunology
MH  - Sepsis/immunology
MH  - Shock, Septic/*immunology/*therapy
EDAT- 2004/07/14 05:00
MHDA- 2004/08/11 05:00
CRDT- 2004/07/14 05:00
PHST- 2003/05/27 00:00 [received]
PHST- 2003/12/24 00:00 [revised]
PHST- 2004/07/14 05:00 [pubmed]
PHST- 2004/08/11 05:00 [medline]
PHST- 2004/07/14 05:00 [entrez]
AID - S0002961004001369 [pii]
AID - 10.1016/j.amjsurg.2003.12.067 [doi]
PST - ppublish
SO  - Am J Surg. 2004 Aug;188(2):150-6. doi: 10.1016/j.amjsurg.2003.12.067.