[Clinical significance of changes in quantitative expression of human leukocyte antigen DR in severely burned patients].
OBJECTIVE
To investigate the clinical significance of kinetic changes in quantitative expression of human leukocyte antigen DR (HLA-DR) in severely burned patients.


METHODS
The blood samples of 77 extensively burned patients (>30% of total body surface area) were serially collected in the present study. The expression of HLA-DR on CD14(+) mononuclear cell surface in burned patients were quantified by flow cytometry (using monoclonal antibody, QuantiBRITETM Anti-HLA-DR PE(*)/Anti-Monocyte PerCP-Cy5.5) on days 1, 3, 5, 7, 14, 21 and 28 post burn.


RESULTS
The expressions of HLA-DR on CD14(+) mononuclear cell surface in severely burned patients were significantly lower than those in healthy volunteers from the first day post burn (P < 0.05), and the value of HLA-DR expression was negatively correlated with the burned area (r = -0.7232, P < 0.05). The expression of HLA-DR in patients complicated with multiple organ dysfunction syndrome (MODS) was persistently decreased following major burns, and it was significantly lower than that of non-MODS patients on days 3, 14, 21 and 28 post burn (P < 0.05). The incidence rate of MODS rose markedly along with the lowering of HLA-DR expression, accompanied with poorer prognosis.


CONCLUSIONS
Extensive burns could result in marked damage in expression of HLA-DR on CD14(+) mononuclear cell surface and immunologic dysfunction. Quantitative measurement of HLA-DR expression might be of significance in forecasting the development of MODS and prognosis in extensively burned patients.
Dong
Ning
N
Burns Institute, First Hospital Affiliated to the China People's Liberation Army General Hospital, Beijing 100037, China.
Yao
Yong-ming
YM
Cao
Yu-jue
YJ
He
Li-xin
LX
Chai
Jia-ke
JK
Xu
Shan
S
Sheng
Zhi-yong
ZY
D000293:Adolescent; D000328:Adult; D002056:Burns / Q000097:blood* / Q000150:complications / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000097:blood*; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D009102:Multiple Organ Failure / Q000097:blood / Q000209:etiology / Q000276:immunology; D011379:Prognosis