title: Reduced monocyte CD86 expression in postinflammatory immunodeficiency.
abstract: OBJECTIVE
  Major surgery, polytrauma, stroke, and pancreatitis frequently lead to a compensatory anti-inflammatory response syndrome that often predisposes patients to lethal infections. This temporary postinflammatory immunodeficiency is characterized by altered function of blood monocytes. These cells show strongly reduced inflammatory and antigen-presentation capacity. Diminished monocyte expression of the major histocompatibility complex class II molecule human leukocyte antigen (HLA)-DR is a well-established diagnostic marker of this immunodeficiency. To further characterize the monocytic cells in this clinical state, we analyzed their expression of CD86, the most important co-stimulatory molecule.
  
  
  METHODS
  Analysis of blood samples that entered the clinical immunologic diagnostics and of cells from an in vitro model of postinflammatory immunodeficiency.
  
  
  METHODS
  University laboratory.
  
  
  METHODS
  Healthy donors and intensive care unit (ICU) patients at the university hospital.
  
  
  METHODS
  None.
  
  
  RESULTS
  The expression of HLA-DR on monocytes and of CD86 and CD80 on monocytes and B cells was analyzed by flow cytometry. Messenger RNA expression of CD86 was analyzed in isolated monocytes by real-time polymerase chain reaction on reverse transcribed. The normal range of monocyte CD86 expression in healthy subjects was established to be from 2128 to 5102 surface molecules per cell and was independent of age, gender, and leukocyte and monocyte count. The CD86 expression on monocytes in ICU patients correlated with HLA-DR expression. Approximately 40% of the ICU patients with long-term reduced monocyte HLA-DR expression had a long-term reduction of CD86 expression. Patients in whom the expression of both molecules was diminished had an unfavorable prognosis. The diminished number of CD86 surface molecules on monocytes was associated with reduced CD86 messenger RNA levels in these cells. The expression of CD86 in B cells was not diminished in immunodeficient patients. The expression of CD80 in both monocytes and B-cells was minimal in healthy donors and not clearly changed in patients.
  
  
  CONCLUSIONS
  The monocyte CD86 expression may be a helpful diagnostic variable in ICU patients.
authors.affiliation: Institute of Medical Immunology and Department of General, Visceral, Vascular, Thoracic Surgery, University Hospital Charité, Berlin, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Wolk
authors.forename: Conny
authors.initials: C
authors.lastname: Höflich
authors.forename: Heidrun
authors.initials: H
authors.lastname: Zuckermann-Becker
authors.forename: Wolf-Dietrich
authors.initials: WD
authors.lastname: Döcke
authors.forename: Hans-Dieter
authors.initials: HD
authors.lastname: Volk
authors.forename: Robert
authors.initials: R
authors.lastname: Sabat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051940:B7-2 Antigen / Q000096:biosynthesis* / Q000097:blood*; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000097:blood* / Q000276:immunology*; D007249:Inflammation / Q000097:blood* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*
chemical_list: D051940:B7-2 Antigen