[Immunological monitoring of sepsis using flow cytometry--quantitation of monocyte HLA-DR expression and granulocyte CD64 expression].
BACKGROUND
Sepsis is a serious disease with a high case fatality rate. A variety of changes in the host immune responsiveness are observed in the pathogenesis of sepsis, ranging from detrimental hyperinflammation to profound immunoparalysis, i.e. acquired immunodeficiency. The level of monocyte HLA-DR expression reflects the functional status of monocytes as antigen-presenting cells and granulocyte CD64 expression is also indicative of infectious inflammation.


METHODS
Monocyte HLA-DR expression and granulocyte CD64 expression were measured in 49 septic patients and 30 healthy controls using flow cytometry focused on three parameters: positive cell percentage, mean fluorescence intensity and quantitation of antibodies bound per cell (QuantiBRITE).


RESULTS
The significance of both monocyte HLA-DR expression and granulocyte CD64 expression in septic patients was confirmed. Monocyte HLA-DR dramatically decreases in septic patients compared to controls, is one of the prognostic factors and correlates with C-reactive protein. In contrast, granulocyte CD64 sharply rises in patients with sepsis and correlates with mediators of systemic inflammation (procalcitonin - PCT), proinflammatory mediators (interleukin-6 - IL-6, lipopolysaccharide binding protein - LBP) and anti-inflammatory cytokines (interleukin-10 - IL10).


CONCLUSIONS
Quantitative monocyte HLA-DR expression and granulocyte CD64 expression are useful indicators in septic patients when considered along with the panel of other markers, monitored over a period of time and in the context of the clinical course of sepsis.
Sedlácková
L
L
Oddĕlení klinické biochemie, hematologie a imunologie, Nemocnice Na Homolce, Praha.
Průcha
M
M
Dostál
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005434:Flow Cytometry; D006098:Granulocytes / Q000276:immunology*; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D017452:Receptors, IgG / Q000032:analysis*; D018805:Sepsis / Q000276:immunology*
D006684:HLA-DR Antigens; D017452:Receptors, IgG