Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection.
In the pathogenesis of sepsis, activation of both pro- and anti-inflammatory responses are key components, but knowledge is lacking on the association between bacterial etiology and development of dysregulated responses with sustained immunosuppression. The aim of this study was to evaluate how the...
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| Format: | Article |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5821339?pdf=render |
| _version_ | 1818511220674658304 |
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| author | Sara Cajander Gunlög Rasmussen Elisabet Tina Anders Magnuson Bo Söderquist Jan Källman Kristoffer Strålin |
| author_facet | Sara Cajander Gunlög Rasmussen Elisabet Tina Anders Magnuson Bo Söderquist Jan Källman Kristoffer Strålin |
| author_sort | Sara Cajander |
| collection | DOAJ |
| description | In the pathogenesis of sepsis, activation of both pro- and anti-inflammatory responses are key components, but knowledge is lacking on the association between bacterial etiology and development of dysregulated responses with sustained immunosuppression. The aim of this study was to evaluate how the immunosupression marker HLA-DR on monocytes (mHLA-DR) is associated with bacterial etiology and markers of inflammation during the clinical trajectory of bloodstream infection (BSI).Ninety-one adults, predominantly non-ICU patients, with BSI caused by Streptococcus pneumoniae (n = 27), Staphylococcus aureus (n = 22), Escherichia coli/Klebsiella pneumoniae (n = 23), and other species (n = 19) were prospectively included, and sampled on admission (day 0) and on days 1-2, 3, 7±1, 14±2, and 28±4.The dynamics of mHLA-DR, measured by flow cytometry, differed significantly between etiology groups (p<0.001). Patients with S. pneumoniae and S. aureus BSI demonstrated low initial mHLA-DR, with the S. aureus group showing delayed recovery over time. Eleven patients (55% S. aureus) had negative outcome (secondary bacteremia or death) and they demonstrated sustained C-reactive protein elevation, neutrophilia, lymphocytopenia, and loss of mHLA-DR.Dynamics of mHLA-DR varied according to the bacterial etiology of infection, with delayed recovery in patients with S. aureus BSI. Patients with negative outcome showed sustained CRP elevation, neutrophilia, lymphocytopenia, and low levels of mHLA-DR, supporting the theory of a dysregulated host response with persistent inflammation and immunosuppression in late stages of deleterious sepsis. |
| first_indexed | 2024-12-10T23:30:26Z |
| format | Article |
| id | doaj.art-1d539a6020b341b4a43084a98d6bb951 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T23:30:26Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1d539a6020b341b4a43084a98d6bb9512022-12-22T01:29:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01132e019288310.1371/journal.pone.0192883Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection.Sara CajanderGunlög RasmussenElisabet TinaAnders MagnusonBo SöderquistJan KällmanKristoffer StrålinIn the pathogenesis of sepsis, activation of both pro- and anti-inflammatory responses are key components, but knowledge is lacking on the association between bacterial etiology and development of dysregulated responses with sustained immunosuppression. The aim of this study was to evaluate how the immunosupression marker HLA-DR on monocytes (mHLA-DR) is associated with bacterial etiology and markers of inflammation during the clinical trajectory of bloodstream infection (BSI).Ninety-one adults, predominantly non-ICU patients, with BSI caused by Streptococcus pneumoniae (n = 27), Staphylococcus aureus (n = 22), Escherichia coli/Klebsiella pneumoniae (n = 23), and other species (n = 19) were prospectively included, and sampled on admission (day 0) and on days 1-2, 3, 7±1, 14±2, and 28±4.The dynamics of mHLA-DR, measured by flow cytometry, differed significantly between etiology groups (p<0.001). Patients with S. pneumoniae and S. aureus BSI demonstrated low initial mHLA-DR, with the S. aureus group showing delayed recovery over time. Eleven patients (55% S. aureus) had negative outcome (secondary bacteremia or death) and they demonstrated sustained C-reactive protein elevation, neutrophilia, lymphocytopenia, and loss of mHLA-DR.Dynamics of mHLA-DR varied according to the bacterial etiology of infection, with delayed recovery in patients with S. aureus BSI. Patients with negative outcome showed sustained CRP elevation, neutrophilia, lymphocytopenia, and low levels of mHLA-DR, supporting the theory of a dysregulated host response with persistent inflammation and immunosuppression in late stages of deleterious sepsis.http://europepmc.org/articles/PMC5821339?pdf=render |
| spellingShingle | Sara Cajander Gunlög Rasmussen Elisabet Tina Anders Magnuson Bo Söderquist Jan Källman Kristoffer Strålin Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. PLoS ONE |
| title | Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. |
| title_full | Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. |
| title_fullStr | Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. |
| title_full_unstemmed | Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. |
| title_short | Dynamics of monocytic HLA-DR expression differs between bacterial etiologies during the course of bloodstream infection. |
| title_sort | dynamics of monocytic hla dr expression differs between bacterial etiologies during the course of bloodstream infection |
| url | http://europepmc.org/articles/PMC5821339?pdf=render |
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