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Low monocyte HLA-DR expression as an indicator of immunodepression in very-low-birth-weight infants.
MedLine Citation:
PMID:  23269117     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:As a protective response to an inflammatory stimulus, the antigen-presenting molecules (HLA-DR) on monocytes are downregulated. If severe, the response may lead to immunodepression or immunoparalysis, associated in adults with increased morbidity and mortality. In very low birth weight (VLBW) infant, birth and intensive care present major immunologic challenges.Methods:We measured monocyte HLA-DR expression by flow cytometry, and determined 13 plasma cytokines in 56 VLBW infants (gestational age (GA) 23.7-31.8) and 25 controls (GA 34.1-41.4).Results:HLA-DR expression decreased postnatally both in VLBW and control infants. In VLBW infants, GA and respiratory distress syndrome (RDS) both showed associations with HLA-DR nadir on day 3, when 45% of them met the criteria of immunodepression. HLA-DR expression was lower in those infants subsequently developing infection (74 vs. 49% (day 3) and 85 vs. 68% (day 7), both P = 0.002). IL-6 on day 1 was a predictor of the HLA-DR nadir.Conclusion:VLBW infants are in a state of immunodepression postnatally. This immunodepression correlated with GA and was a predisposing factor for late infections. The downregulation of HLA-DR during RDS probably indicates a RDS- induced antigen load on the immune system.Pediatric Research (2012); doi:10.1038/pr.2012.199.
Authors:
Anniina Palojärvi; Jari Petäjä; Sanna Siitonen; Cecilia Janér; Sture Andersson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-26
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neonatology, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
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