CD14 expression in injured patients correlates with outcome.
OBJECTIVE
The authors determined the correlation between monocyte CD14 expression and outcome in severely injured patients.


BACKGROUND
Human leukocyte antigen-DR (HLA-DR) expression CD14 positive monocytes correlates with the development of major infection and subsequent death in severely injured patients. Recent studies show that CD14 is not only a marker for mature monocytes, but also is an important endotoxin/lipopolysaccharide receptor.


METHODS
Flow cytometry data obtained by dual staining techniques (CD14 and HLA-DR) of monocytes in 213 severely injured patients were analyzed over a 30-day period. Outcome criteria included survival and the development of both major and minor infections.


RESULTS
The percentage of cells expressing CD14 (%CD14) correlated with clinical outcome, reaching significance (p < 0.05) between noninfected survivors (n = 74) and nonsurvivors (n = 21) at days 3, 7, 11, 17, 24, and 30. At days 3, 7, and 17, the %CD14 also was different between noninfected and infected survivors. After 7 days, differences were only seen between survivors and nonsurvivors (p < 0.05). The mean fluorescence intensity (MC CD14) in monocytes of all patients was significantly reduced at day 3 compared with day 1 and remained low for 30 days (p < 0.05). The nonsurvivor group had consistently low MC CD14 values, which were significant at day 5 (p < 0.05).


CONCLUSIONS
In addition to HLA-DR expression, CD14 expression on monocytes is an indicator of clinical outcome after injury and could represent a more precise target for treatment.
Heinzelmann
M
M
Price Institute of Surgical Research, Department of Surgery, University of Louisville, School of Medicine, Kentucky 40292, USA.
Mercer-Jones
M
M
Cheadle
W G
WG
Polk
H C
HC
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D006684:HLA-DR Antigens / Q000097:blood; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D009000:Monocytes / Q000276:immunology; D011446:Prospective Studies; D017741:Survivors / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications / Q000276:immunology* / Q000401:mortality / Q000628:therapy
D006684:HLA-DR Antigens; D018950:Lipopolysaccharide Receptors