title: Impaired Surface Expression of HLA-DR, TLR2, TLR4, and TLR9 in Ex Vivo-In Vitro Stimulated Monocytes from Severely Injured Trauma Patients.
abstract: Objective. Trauma patients (TP) frequently develop an imbalanced immune response that often causes infectious postinjury complications. Monocytes show a diminished capability of both producing proinflammatory cytokines and antigen presentation after trauma. TLR2, TLR4, and TLR9 recognize pathogens and subsequently activate monocytes. While there are conflictive data about TLR2 and TLR4 expression after trauma, no studies about the expression of TLR2, TLR4, TLR9, and HLA-DR on monocytes from TP after their secondary ex vivo-in vitro "hit" have been reported.Methods/Results. Ex vivo-in vitro lipopolysaccharide- (LPS-) stimulated blood from TP showed diminished interleukin- (IL-) 1β-release in TP for five postinjury days compared to healthy volunteers (HV). The recovery was observed at day 5. In parallel, monocytes from TP showed an impaired capability of TLR2, TLR4, and TLR9 expression after secondary stimulation compared to HV, while the measurement of unstimulated samples showed significant reduction of TLR4 and TLR9 at ED. Furthermore, HLA-DR decreased after trauma and was even more profound by stimulation of monocytes. Ratio of monocytes to leukocytes was significantly increased at days 6 and 7 after trauma compared to HV.Conclusion. Impaired expression of TLRs and HLA-DR in acute inflammatory conditions may be responsible for the well-described monocyte paralysis after severe trauma.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Heftrig
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Ramona
authors.initials: R
authors.lastname: Sturm
authors.affiliation: Department of General and Visceral Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Elsie
authors.initials: E
authors.lastname: Oppermann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Kontradowitz
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Katrin
authors.identifier: 0000-0002-8271-6349
authors.initials: K
authors.lastname: Jurida
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Schimunek
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Woschek
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.
authors.forename: Borna
authors.identifier: 0000-0002-5625-8823
authors.initials: B
authors.lastname: Relja
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011446:Prospective Studies; D051195:Toll-Like Receptor 2 / Q000378:metabolism*; D051197:Toll-Like Receptor 4 / Q000378:metabolism*; D051217:Toll-Like Receptor 9 / Q000378:metabolism*; D014947:Wounds and Injuries / Q000378:metabolism*; D055815:Young Adult
chemical_list: D006684:HLA-DR Antigens; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4; D051217:Toll-Like Receptor 9