PMID- 22089188
OWN - NLM
STAT- MEDLINE
DCOM- 20120521
LR  - 20120117
IS  - 1540-0514 (Electronic)
IS  - 1073-2322 (Linking)
VI  - 37
IP  - 2
DP  - 2012 Feb
TI  - Clinical outcome of critically ill patients cannot be defined by cutoff values of 
      monocyte human leukocyte antigen-DR expression.
PG  - 140-4
LID - 10.1097/SHK.0b013e31823f1866 [doi]
AB  - Septic shock is the most common cause of death in intensive care units. During 
      the last two decades, new strategies have focused on the diagnosis and on the 
      immunological changes in critically ill patients. There have been conflicting 
      reports whether monocyte human leukocyte antigen (HLA) DR expression poses a 
      useful parameter to characterize clinical outcome of these patients. To elucidate 
      the role of monocyte HLA-DR expression, we hypothesized that low expression of 
      HLA-DR on circulating human monocytes in critically ill patients correlates with 
      higher mortality and that cutoff values of HLA-DR discriminate surviving from 
      nonsurviving patients. In this retrospective study, monocyte HLA-DR expression in 
      413 critically ill patients was investigated during their intensive care unit 
      stay. Human leukocyte antigen DR was determined in a quantitative and 
      standardized procedure by flow cytometry (anti-HLA-DR monoclonal antibodies bound 
      per cell [mABs/cell]) at least every third day or when clinical changes in the 
      patients conditions were observed. Healthy probands served as control group to 
      determine the range of "normal" values. As expected, HLA-DR expression was 
      significantly higher in the group of survivors (n = 279) than in the group of 
      nonsurvivors (n = 134; mABs/cell: 23,038 [SD, 11,150] vs. 18,070 [SD, 8,906]; P < 
      0.001). When minimal HLA-DR values per patient were compared, no cutoff values 
      could be identified between the groups of survivors and nonsurvivors (mABs/cell: 
      19,611 [SD, 11,129] vs. 14,944 [SD, 8,013]; P < 0.001). In conclusion, in this 
      sizable cohort we could again show that HLA-DR expression is decreased in 
      critically ill patients but it is not suitable as a prognostic or predictive 
      parameter for clinical outcome.
FAU - Trimmel, Helmut
AU  - Trimmel H
AD  - Department of Anaesthesiology, Emergency Medicine and Intensive Care, Wiener 
      Neustadt General Hospital, Vienna, Austria.
FAU - Luschin, Ursula
AU  - Luschin U
FAU - Kohrer, Karin
AU  - Kohrer K
FAU - Anzur, Christian
AU  - Anzur C
FAU - Vevera, Daniela
AU  - Vevera D
FAU - Spittler, Andreas
AU  - Spittler A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Shock
JT  - Shock (Augusta, Ga.)
JID - 9421564
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Critical Illness/mortality/*therapy
MH  - Female
MH  - Flow Cytometry/methods
MH  - *Gene Expression Regulation
MH  - HLA-DR Antigens/*immunology
MH  - Humans
MH  - Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - Monocytes/cytology/*immunology/metabolism
MH  - Prognosis
MH  - Retrospective Studies
MH  - Sepsis/mortality/therapy
MH  - Treatment Outcome
EDAT- 2011/11/18 06:00
MHDA- 2012/05/23 06:00
CRDT- 2011/11/18 06:00
PHST- 2011/11/18 06:00 [entrez]
PHST- 2011/11/18 06:00 [pubmed]
PHST- 2012/05/23 06:00 [medline]
AID - 10.1097/SHK.0b013e31823f1866 [doi]
PST - ppublish
SO  - Shock. 2012 Feb;37(2):140-4. doi: 10.1097/SHK.0b013e31823f1866.