Dynamics of Human Leukocyte Antigen-D Related expression in bacteremic sepsis

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Cajander, Sara,1980-Örebro universitet,Institutionen för medicinska vetenskaper (författare)

Dynamics of Human Leukocyte Antigen-D Related expression in bacteremic sepsis

BokEngelska2017

Förlag, utgivningsår, omfång ...

Örebro :Örebro University,2017
97 s.
electronicrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:oru-56125
ISBN:9789175291918
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-56125URI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:vet swepub-contenttype
Ämneskategori:dok swepub-publicationtype

Serie

Örebro Studies in Medicine,1652-4063 ;161

Anmärkningar

Monocytic human leukocyte antigen-D related (mHLA-DR) expression determined by flow cytometry has been suggested as a biomarker of sepsisinduced immunosuppression.In order to facilitate use of HLA-DR in clinical practice, a quantitative real-time PCR technique measuring HLA-DR at the transcription level was developed and evalutated. Levels of HLA-DR mRNA correlated to mHLADR expression and were robustly measured, with high reproducibility, during the course of infection. Dynamics of mHLA-DR expression was studied during the first weeks of bloodstream infection (BSI) and was found to be dependent on the bacterial etiology of BSI. Moreover, mHLA-DR was shown to be inversely related to markers of inflammation. In patients with unfavourable outcome, sustained high C-reactive protein level and high neutrophil count were demonstrated along with low mHLA-DR expression and low lymphocyte count. This supports the theory of sustained inflammation in sepsis-induced immunosuppression. The association between mHLA-DR and bacterial etiology may be linked to the clinical trajectory via differences in ability to cause intractable infection. Staphylococcus aureus was the dominating etiology among cases with unfavourable outcome. With focus on patients with S. aureus BSI, those with complicated S. aureus BSI were found to have lower HLA-DR mRNA expression during the first week than those with uncomplicated S. aureus BSI. If these results can be confirmed in a larger cohort, HLA-DR measurement could possibly become an additional tool for early identification of patients who require further investigation to clear infectious foci and achieve source control.In conclusion, PCR-based measurement of HLA-DR is a promising method for measurements of the immune state in BSI, but needs further evaluation in the intensive care unit setting to define the predictive and prognostic value for deleterious immunosuppression. The etiology of infection should be taken into consideration in future studies of translational immunology in sepsis.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
monocyte HLA-DR
sepsis
immunosuppression
bloodstream infection
HLA-DRA
CIITA
qRT-PCR

Biuppslag (personer, institutioner, konferenser, titlar ...)

Källman, Jan,docent,1958-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)jnka (preses)
Strålin, KristofferKarolinska Universitetssjukhuset (preses)
Söderquist, Bo,professor,1955-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)bost (preses)
Åkesson, Per,docentInfektionskliniken Lunds Universitetssjukhus (opponent)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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Av författaren/redakt...: Cajander, Sara, ...; Källman, Jan, do ...; Strålin, Kristof ...; Söderquist, Bo, ...; Åkesson, Per, do ...

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