Proinflammatory blood monocytes: main effector and target cells in systemic and renal disease; background and therapeutic implications.
Although peripheral blood monocytes are heterogeneous, they all express the CD14 molecule, a multifunctional receptor, and part of the toll-like membrane receptor complex. In healthy persons, a minor subset (8%) coexpresses CD14 and CD16, a low affinity Fc-gamma type III receptor. This subpopulation shows characteristics of tissue macrophages and expands greatly in acute and chronic infections, systemic inflammatory syndromes, hyperlipidedemia, AIDS and renal failure. CD14+/CD16+ monocytes (Mo) exhibit higher phagocytosis activity than CD14++/CD16-negative monocytes and synthesize high levels of interleukin-1, TNF-alpha and HLA-DR, -DP and -DQ antigens. Glucocorticoids (and interleukin-4), and successful therapy in patients with inflammatory and septic complications lead to a down-regulation in the expression of CD14 and deplete CD14+/CD16+-proinflammatory Mo. Recovery of low monocytic HLA-DR expression parallels clinical improvement. Serial analyses of Mo phenotypes may be useful tools for monitoring patients receiving immunosuppressive and anti-inflammatory therapy respectively.
Scherberich
J E
JE
Second Medical Department, Hospital Munich-Harlaching, Academic Educational Hospital, Ludwig-Maximilians-University, Munich, Germany. JScherberich@Nierenzentrum.de
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000276:immunology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015703:Antigens, CD / Q000097:blood / Q000276:immunology; D015536:Down-Regulation; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D009000:Monocytes / Q000187:drug effects*; D006435:Renal Dialysis
D000900:Anti-Bacterial Agents; D015703:Antigens, CD; D005938:Glucocorticoids