Christopher Sachse, Maren Prigge, Gebhard Cramer, Norbert Pallua, Eberhard Henkel
Association between Reduced Human Leukocyte Antigen (HLA)-DR Expression on Blood Monocytes and Increased Plasma Level of Interleukin-10 in Patients with Severe Burns
Severe thermal injury causes an immune dysfunction
which includes a decrease of monocyte human leukocyte
antigen DR (HLA-DR) expression. Interleukin-10
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 monocyte HLA-DR and plasma interleukin-10
concentration. Both quantities were measured serially
in 19 patients with severe burns. HLA-DR expression
was determined by direct immunofluorescence on a
flow cytometer, and interleukin-10 was measured by
ELISA. After burn trauma the percentage of HLA-DR
expressing monocytes fell markedly (median: 53 % at
day 2, 36 % at day 4, 31 % at 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 lower 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 concentrations
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 concentration were negatively correlated, the
association reaching statistical significance at day 4
(p = 0.006) and day 7 (p = 0.031). Thus, after severe burn
injury monocyte HLA-DR expression has prognostic
value and is negatively associated with interleukin-10
plasma concentration.
Clinical Chemical Laboratory Medicine, Walter de Gruyter
Print ISSN: 1434-6621
Volume: 37, 03/1999
Pages: 193 - 198
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