Association between reduced human leukocyte antigen (HLA)-DR expression onblood monocytes and increased plasma level of interleukin-10 in patients with severe burns
C. Sachse et al., Association between reduced human leukocyte antigen (HLA)-DR expression onblood monocytes and increased plasma level of interleukin-10 in patients with severe burns, CLIN CH L M, 37(3), 1999, pp. 193-198
Severe thermal injury causes an immune dysfunction which includes a decreas
e of monocyte human leukocyte antigen DR (HLA-DR) expression. Interleukin-1
0 exerts a negative influence on this parameter in vitro. In this study we
determined the prognostic value of reduced monocyte HLA-DR expression with
regard to infectious complications, and the in vivo association between mon
ocyte HLA-DR and plasma interleukin-10 concentration. Both quantities were
measured serially in 19 patients with severe burns. HLA-DR expression was d
etermined by direct immunofluorescence on a flow cytometer, and interleukin
-10 was measured by ELISA. After burn trauma the percentage of HLA-DR expre
ssing monocytes fell markedly (median: 53 % at day 2, 36 % at day 4, 31 % a
t day 7, 28 % at day 9, 35 % at day 12, and 42 % at day 14; compared to 93
% for healthy volunteers). Moreover, patients who became septic showed lowe
r monocyte HLA-DR expression than non-septic patients; the differences were
significant at day 2 (p < 0.01) and day 7 (p < 0.05). Plasma concentration
s of interleukin-10 increased after thermal injury (median: 40 ng/l at day
2, 43 ng/l at day 4, 77 ng/l at day 7, 120 ng/l at day 9, 63 ng/l at day 12
, and 82 ng/l at day 14). Individual HLA-DR expression and interleukin-10 c
oncentration were negatively correlated, the association reaching statistic
al significance at day 4 (p = 0.006) and day 7 (p = 0.031). Thus, after sev
ere burn injury monocyte HLA-DR expression has prognostic value and is nega
tively associated with interleukin-10 plasma concentration.