Depressed interferon gamma production and monocyte HLA-DR expression after severe injury
D. H. Livingston, S. H. Appel, S. R. Wellhausen, G. Sonnenfeld and H. C. Polk Jr
Department of Surgery, Price Institute of Surgical Research, School of Medicine, University of Louisville, KY 40292.
Monocyte HLA-DR antigen expression and mitogen-stimulated interferon gamma
production were measured sequentially on days 1, 3, 7, 14, and 21 after
admission in 20 multiply injured patients (mean Injury Severity Score, 33).
Ten patients recovered uneventfully and ten developed a major infection,
three of whom died. Trauma resulted in immediate and profound depression of
both interferon gamma production and monocyte HLA-DR antigen expression
compared with controls. Interferon gamma remained below control levels for
all days on which it was measured in all patients. In uninfected patients,
interferon gamma production began to recover after day 7 and interferon
gamma levels on day 21 were greater than on all other days. Monocyte HLA-DR
antigen expression returned to normal between days 7 and 14 in uninfected
patients, despite subnormal production of interferon gamma. Failure to
increase interferon gamma production and monocyte HLA-DR antigen expression
was associated with an episode of major infection. We postulate that
stimulation of the immune system early after injury may reverse the defects
reported and decrease the incidence of infection after severe trauma.
Castration prevents suppression of MHC class II (Ia) expression on macrophages after trauma-hemorrhage
Mayr et al.
J. Appl. Physiol. 2006;101:448-453.
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The Effect of Local Anesthetics on Monocyte mCD14 and Human Leukocyte Antigen-DR Expression
Kawasaki et al.
Anesth. Analg. 2004;98:1024-9.
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Interferon-{gamma} increases monocyte HLA-DR expression without effects on glucose and fat metabolism in postoperative patients
de Metz et al.
J. Appl. Physiol. 2004;96:597-603.
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Stroke-induced Immunodeficiency Promotes Spontaneous Bacterial Infections and Is Mediated by Sympathetic Activation Reversal by Poststroke T Helper Cell Type 1-like Immunostimulation
Prass et al.
JEM 2003;198:725-736.
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"Septic Plasma": An Immunosuppressive Milieu
Cavaillon
Am. J. Respir. Crit. Care Med. 2002;166:1417-1418.
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Glutamine-Enriched Enteral Nutrition Increases HLA-DR Expression on Monocytes of Trauma Patients
Boelens et al.
J. Nutr. 2002;132:2580-2586.
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Surgical Stress Induces Endotoxin Hyporesponsiveness and an Early Decrease of Monocyte mCD14 and HLA-DR Expression During Surgery
Kawasaki et al.
Anesth. Analg. 2001;92:1322-1326.
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Interferon-{gamma} counteracts reduced endotoxin responsiveness of whole blood following trauma and cardiopulmonary bypass
Flohe et al.
Innate Immunity 2000;6:431-436.
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Expanded CD14+ CD16+ Monocyte Subpopulation in Patients with Acute and Chronic Infections Undergoing Hemodialysis
Nockher and Scherberich
Infect. Immun. 1998;66:2782-2790.
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Endotoxemia-related attenuation of interleukin-1 secretion in thermally injured patients
Cembrzynska-Nowak et al.
Innate Immunity 1994;1:92-100.
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