| Decreased monocyte human leukocyte antigen-DR expression after severe burn injury: Correlation with severity and secondary septic shock. | |
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MedLine Citation:
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PMID: 17568330 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Severe thermal injury causes immune dysfunctions involving both pro- and anti-inflammatory mechanisms. It subsequently leads to a state of immune deficiency that shares some similarities with sepsis-induced immunosuppression. A hallmark of the latter is established by decreased monocyte human leukocyte antigen-DR (mHLA-DR) measurements. The main objective of the current study was to characterize the appearance and the duration of low mHLA-DR expression after severe burn as well as to determine its correlation with mortality and septic complications. DESIGN: Observational study. SETTING: Burn unit (intensive care unit) in a university hospital. PATIENTS: Severe burn patients (total burn surface area >30%, n = 14) and healthy individuals (n = 29). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were immunologically monitored during 15 days. We quantified mHLA-DR expression with a standardized flow cytometry protocol. Every patient presented with decreased mHLA-DR expression at days 2-3 after burn. Then, from days 4-6, this expression increased in patients who would survive whereas it remained low in nonsurvivors. As early as days 7-10 after burn, patients who were going to develop secondary septic shock exhibited significantly lower mHLA-DR expression in comparison with patients recovering without severe septic complications. Using quantitative reverse transcriptase-polymerase chain reaction, at days 4-6, we found that the RNA level of the nonpolymorphic HLA-DRA chain and the transcription factor class II transactivator were also significantly decreased compared with healthy controls; however, plasma cytokines (interleukin-6, tumor necrosis factor-alpha, and interleukin-10) did not provide any significant prognostic information. CONCLUSIONS: Severe burn injury induced a marked reduction in mHLA-DR expression at both protein and messenger RNA levels. Its persistent decrease was associated with mortality and the development of septic complications. |
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Authors:
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Fabienne Venet; Sylvie Tissot; Anne-Lise Debard; Caroline Faudot; Carine Crampé; Alexandre Pachot; Alfred Ayala; Guillaume Monneret |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 35 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-08-16 Completed Date: 2007-11-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1910-7 Citation Subset: AIM; IM |
Affiliation:
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Hospices Civils de Lyon, Hôpital Neurologique, Laboratoire d'Immunologie, Lyon, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Biological Markers / blood Burns / complications, immunology* Female HLA-DR Antigens / blood* Humans Immunocompromised Host / immunology* Interleukin-10 / blood Interleukin-6 / blood Male Middle Aged Monocytes / immunology* Shock, Septic / etiology, immunology*, prevention & control Survival Analysis Trauma Severity Indices Tumor Necrosis Factor-alpha / blood |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/HLA-DR Antigens; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; 130068-27-8/Interleukin-10 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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