Details

Autor(en) / Beteiligte

• Monneret, Guillaume
• Finck, Marie-Emmanuelle
• Venet, Fabienne
• Debard, Anne-Lise
• Bohé, Julien
• Bienvenu, Jacques
• Lepape, Alain

Titel

The anti-inflammatory response dominates after septic shock: association of low monocyte HLA-DR expression and high interleukin-10 concentration

Ist Teil von

• Immunology letters, 2004-09, Vol.95 (2), p.193-198

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2004

Quelle

MEDLINE

Beschreibungen/Notizen

• The diminished expression of HLA-DR on monocytes has been proposed as a reliable marker of immunosuppression occuring during septic shock. The objective of the present observational study was to establish the time-dependent relation between plasma cytokines interleukin (IL)-10, transforming growth factor (TGF)-β1, tumor necrosis factor (TNF)-α and monocyte HLA-DR expression in 38 adult patients with septic shock. All patients (mortality at 28 days: 42%, mean admission SAPS II score: 54) had decreased HLA-DR expression. This expression was significantly lower in non-survivors at all time points. All patients had elevated IL-10 concentrations, the highest values were found in non-survivors. IL-10 was the sole cytokine to significantly correlate with HLA-DR expression ( r: −0.6, p < 0.001). TNF and TGF values did not provide any prognostic information. TGF levels from septic patients were even found to be decreased in comparison with normal values which suggested that IL-10 is likely more important than TGF regarding the immunosuppressive properties of septic patients’ plasma. This preliminary work showed that, at the systemic level, the anti-inflammatory response dominated after septic shock. Monocyte HLA-DR expression and IL-10 measurement deserve to be determined in parallel in a larger longitudinal study. They might constitute helpful indicators for staging patients and making a decision about whether to institute a therapy with molecules able of reversing sepsis-induced immunosuppression.