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Alterations in Function and Phenotype of Monocytes from Patients with Septic Disease: Predictive Value and New Therapeutic Strategies

  • H. D. Volk
  • M. Thieme
  • U. Ruppe
  • S. Heym
  • W. D. Döcke
  • D. Manger
  • S. Zuckermann
  • A. Golosubow
  • B. Nieter
  • H. Klug
  • R. van Baehr

Abstract

Recently we described the usefulness of immune monitoring as a guide for immunosuppression in allograft recipients with septic complications [1]. From cytofluorometric analyses of mononuclear cells (MNC), the HLA-DR antigen expression on monocytes seems to be the most important diagnostic parameter for the clinical management of immunosuppressed patients with sepsis. A restitution of diminished HLA-DR antigen expression on monocytes after rapid decline of immunosuppression was associated with a favorable outcome of sepsis [1]. Further studies on surgical patients suffering from septic disease (peritonitis as septic focus) not receiving therapeutically induced immunosuppression confirmed the predictive value of HLA-DR antigen expression on monocytes for clinical outcome [2, 3]. Taking a proportion of HLA-DR+ monocytes lower than 20% as the threshold for predicting fatal outcome, we correctly classified survivors and nonsurvivors in all but one case (n = 38) between the 5th and 7th days after admission to the ICU.

Keywords

Septic Patient Tetanus Toxoid Septic Complication Immune Monitoring Septic Focus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag, Berlin Heidelberg 1993

Authors and Affiliations

  • H. D. Volk
    • 1
  • M. Thieme
    • 1
    • 2
  • U. Ruppe
    • 1
    • 2
  • S. Heym
    • 1
  • W. D. Döcke
    • 1
  • D. Manger
    • 2
  • S. Zuckermann
    • 2
  • A. Golosubow
    • 3
  • B. Nieter
    • 4
  • H. Klug
    • 3
  • R. van Baehr
    • 1
  1. 1.Institute For Medical Immunology, CharitéHumboldt-Universität BerlinBerlinGermany
  2. 2.Clinic For Surger, CharitéHumboldt-Universität BerlinBerlinGermany
  3. 3.Clinic For Intensive Care, CharitéHumboldt-Universität BerlinBerlinGermany
  4. 4.Clinic For Internal Medicine, CharitéHumboldt-Universität BerlinBerlinGermany

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