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Title: Characterization of circulating monocytes expressing HLA-DR or CD71 and related soluble factors for 2 weeks after severe, non-thermal injury
Authors: Douglas S. Walsh
Parinya Thavichaigarn
Kovit Pattanapanyasat
Pricha Siritongtaworn
Prapassorn Kongcharoen
Pongsri Tongtawe
Kosol Yongvanitchit
Narongchai Jiarakul
Chullathep Dheeradhada
Frederick J. Pearce
William P. Wiesmann
H. Kyle Webster
Armed Forces Research Institute of Medical Sciences, Thailand
Royal Thai Army
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Police Hospital
Walter Reed Army Institute of Research
Eisenhower Army Medical Center
Keywords: Medicine
Issue Date: 1-Dec-2005
Citation: Journal of Surgical Research. Vol.129, No.2 (2005), 221-230
Abstract: Background. Severe injury is associated with changes in monocytes that may contribute to poor outcomes. Longitudinal characterization of monocyte response patterns after trauma may provide added insight into these immunological alterations. Methods. Venous blood obtained seven times during post-injury days 1 through 13 from 61 patients with an injury severity score >20 was assessed by flow cytometry for monocytes (CD14+) expressing HLA-DR or CD71 (transferrin receptor) and for circulating levels of interleukin (IL) 1α, IL-1β, IL-6, soluble CD14 (sCD14), tumor necrosis factor-α (TNF-α), prostaglandin E2(PGE2), thromboxane B2(TXB2), and endotoxin. Urine neopterin was measured by high-pressure liquid chromatography, expressed as a neopterin-creatinine ratio. Results. Trauma patients had leucocytosis days 1 through 13, monocytosis days 5 through 13, reduced proportions of CD14+HLA-DR+ cells days 2 through 5, and elevated proportions of CD14+CD71+ cells days 1 through 13. Neopterin was elevated all days, peaking on day 10. sCD14 was elevated days 2 through 13, and there were sporadic elevations of IL-1α, IL-1β, IL-6, TNF-α, PGE2, TXB2, and endotoxin. Sepsis syndrome patients (n = 6) had larger and more prolonged reductions in CD14+HLA-DR+ cells and higher neopterin values, in comparison with uneventful patient outcomes. Conclusions. Altered proportions of monocytes expressing HLA-DR and CD71 and elevated sCD14 and urine neopterin levels, for up to 2 weeks after severe injury, underscores an extended period of profound immunological effects. Additional studies to more fully assess temporal monocyte response patterns after severe injury, including activation, may be warranted. © 2005 Elsevier Inc. All rights reserved.
ISSN: 10958673
Appears in Collections:Scopus 2001-2005

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