There is increasing evidence for a protective role of Human-Leukocyte-Antigen (HLA)-DQ in response to infection. This study was performed: (1) to investigate the kinetics of monomorphic (m)HLA-II (HLA-DR,-DP,-DQ) and HLA-DQ expression on monocytes during septic shock; (2) to clarify whether maintaining mHLA-II and HLA-DQ expression within normal range (NR) could predict improved recovery and survival. In total, 16 patients (11 males, 5 females) in septic shock have been investigated. mHLA-II and HLA-DQ median fluorescence intensity (MFI) on monocytes have been monitored daily using flow cytometry. Normal range was determined in 19 healthy volunteers. MFI of mHLA-II and HLA-DQ expression throughout septic shock was significantly reduced when compared to control (P < 0.05). All patients showed median mHLA-II expression below normal range regardless of duration of septic shock and survival. In contrast, median HLA-DQ expression demonstrated negative correlation with the duration of septic shock (Phi-square = 0.73). Patients with HLA-DQ below normal range showed almost a three-fold prolonged term of septic shock as compared to patients with HLA-DQ expression within normal range (15.2 ± 6.3 days versus 5.5 ± 1.7 days; P < 0.015). Although, there was no correlation between median HLA-DQ and survival, all non-survivors showed HLA-DQ expression below normal range. In conclusion, HLA-DQ expression below normal range may predict prolonged duration of septic shock and increased mortality and could be an indicative marker of immune surveillance in critically ill patients.
Authors and Affiliations
Department of Anesthesia, University Clinic of Ulm, Steinhoevelstr. 9, 89075, Ulm, Germany
SJ Voglic, G Fischer, E Barth, T Weckmann, M Georgieff & M Weiss
Voglic, S., Fischer, G., Barth, E. et al. Decreased monocyte surface expression of HLA-DQ is associated with prolonged duration of septic shock.
(Suppl 1), P107 (2002). https://doi.org/10.1186/cc1560