Esther Fernández-Grande1, Carmen María Cabrera2, Blanca González3, Carolina Varela4, José Miguel Urra5. 1. Immunology, Hospital General Universitario de Ciudad Real, Spain. Electronic address: e.fernandezgrande@gmail.com. 2. Immunology, Hospital Regional Universitario Carlos Haya, Málaga, Spain. 3. Immunology, Hospital General Universitario de Ciudad Real, Spain. 4. Preventive Medicine, Hospital General Universitario de Ciudad Real, Spain. 5. Immunology, Hospital General Universitario de Ciudad Real, Spain; Medicine Faculty-Ciudad Real, Universidad de Castilla La Mancha, Spain.
Abstract
INTRODUCTION: Early detection of sepsis is a critical step to improve patient's survival and cellular markers effective diagnosis tools. The aim of this work was to evaluate HLA-DR expression on peripheral T-lymphocytes (CD3+), a marker associate to T-cell activation, as an early sepsis detection tool. PATIENTS AND METHODS: A cross-sectional study was conducted in twenty-six patients with confirmed sepsis by blood culture, eighteen healthy individuals and four patients with systemic inflammatory response syndrome. The analysis of the HLA-DR expression was carried by flow cytometry. RESULTS: The patients with confirmed sepsis had significantly higher percentage of CD3+/HLA-DR+ lymphocytes compared with both, patients with SIRS (20.37±9.42 vs. 8.7±2.9; p<0.005) and healthy individuals (20.37±9.42 vs. 6.58±3.89; p<0.005). Moreover, the average amount of HLA-DR expressed was higher when caused by gram-positive than by gram-negative bacterias (216.61±131.35 vs. 135.05±31.82; p=0.041). A ROC curve analysis showed the utility of HLA-DR expression on T-cells to identify patients with sepsis. DISCUSSION: Our results suggest that surface expression of HLA-DR on T-lymphocytes could be an early marker for the presence of sepsis in non-surgical septic patients.
INTRODUCTION: Early detection of sepsis is a critical step to improve patient's survival and cellular markers effective diagnosis tools. The aim of this work was to evaluate HLA-DR expression on peripheral T-lymphocytes (CD3+), a marker associate to T-cell activation, as an early sepsis detection tool. PATIENTS AND METHODS: A cross-sectional study was conducted in twenty-six patients with confirmed sepsis by blood culture, eighteen healthy individuals and four patients with systemic inflammatory response syndrome. The analysis of the HLA-DR expression was carried by flow cytometry. RESULTS: The patients with confirmed sepsis had significantly higher percentage of CD3+/HLA-DR+ lymphocytes compared with both, patients with SIRS (20.37±9.42 vs. 8.7±2.9; p<0.005) and healthy individuals (20.37±9.42 vs. 6.58±3.89; p<0.005). Moreover, the average amount of HLA-DR expressed was higher when caused by gram-positive than by gram-negative bacterias (216.61±131.35 vs. 135.05±31.82; p=0.041). A ROC curve analysis showed the utility of HLA-DR expression on T-cells to identify patients with sepsis. DISCUSSION: Our results suggest that surface expression of HLA-DR on T-lymphocytes could be an early marker for the presence of sepsis in non-surgical septic patients.
Authors: Vandana Chaturvedi; Rebecca A Marsh; Adi Zoref-Lorenz; Erika Owsley; Vijaya Chaturvedi; Trung C Nguyen; Jordana R Goldman; Michael M Henry; Jay N Greenberg; Stephan Ladisch; Michelle L Hermiston; Michael Jeng; Ahmed Naqvi; Carl E Allen; Hector R Wong; Michael B Jordan Journal: Blood Date: 2021-04-29 Impact factor: 25.476