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.
KeywordsProstaglandin Thymidine Peritonitis Tetanus
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