Alterations in Function and Phenotype of Monocytes from Patients with Septic Disease: Predictive Value and New Therapeutic Strategies
Recently we described the usefulness of immune monitoring as a guide for immunosuppression in allograft recipients with septic complications . 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 . 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.
KeywordsSeptic Patient Tetanus Toxoid Septic Complication Immune Monitoring Septic Focus
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- 1.Volk HD, Reinke P, Falck P et al. (1989) Diagnostic value of an immune monitoring program for the clinical management of immunosuppressed patients with septic complications. Clin Transplant 3:246–252Google Scholar
- 2.Von Baehr R, Lohmann T, Heym S et al. (1990) Immunoparalysis in case of septicaemia. Z Klin Med 45:1133–1137Google Scholar
- 3.Volk HD, Lohmann T, Heym S et al. (1990) Decrease of proportion of HLA-DR+ monocytes as prognostic parameter for the clinical outcome of septic disease. In: Masihi KN, Lange W (eds) Immunotherapeutic Springer, Berlin Heidelberg New York, pp 297–301Google Scholar
- 4.Falck P, Volk HD, Kiowski S et al. (1987) Characterization of mononuclear cells by means of monoclonal antibodies and cytofluorometry. Z Klin Med 42:2281–2284Google Scholar
- 8.Heumann D, Vischer TL (1988) Immunomodulation by α2-macroglobulin and α2-macro-globulin-proteinase complexes: the effect on the human T lymphocyte response. Eur J Immunol 26:246–249Google Scholar