HLA-DR expression and differential trafficking of monocyte subsets following low to intermediate risk surgery
HLA-DR expression and differential trafficking of monocyte subsets following low to intermediate risk surgery
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DOI：
10.1111/j.1365-2044.2009.06161.x
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发表时间：
2010-01-01
期刊：
影响因子：
10.7
通讯作者：
Takata, M.
中科院分区：
文献类型：
--
作者：
Handy, J. M.;Scott, A. J.;Takata, M.
单核细胞上HLA-DR表达的降低已被认为是极高风险手术后免疫抑制的预测标志物，但在低风险手术中的报道很少。在32名接受低至中等风险手术的患者中，通过流式细胞术分析血液样本的HLA-DR表达以及CD 14（高）和CD 14（低）CD 16+单核细胞亚群的数量。CD 14（高）单核细胞数量在24 h时增加（平均值（SD），5.0（2.2）vs 7.6（3.9）x 10（5）个细胞）。ml（-1）; p < 0.01），而CD 14（低）CD 16+单核细胞减少（0.68（0.36）vs 0.44（0.36）x 10（5）个细胞）。ml（-1）; p < 0.01）。HLA-DR表达在两个亚群中到24小时显著降低（平均（SD）荧光强度440（310）对CD 14（高）的160（130）和1000（410）对CD 14（低）的560（380）; p < 0.01）。这种低风险手术后24小时单核细胞HLA-DR表达的减少引起了关于该生物标志物作为术后并发症早期预测因子的所谓临床效用的问题。我们的研究结果还表明，手术诱导单核细胞亚群的显著贩运（即动员，边缘化和外渗），单核细胞HLA-DR抑制是下调现象的结果（每个细胞上的蛋白质表达减少），而不是单核细胞亚群的差异贩运。
Reduced HLA-DR expression on monocytes has been suggested as a predictive marker of immunosuppression following very high risk surgery, but there are few reports in lower risk surgery. In 32 patients undergoing low to intermediate risk surgery, blood samples were analysed by flow cytometry for HLA-DR expression and numbers in both CD14(high) and CD14(low) CD16+ monocyte subsets. The numbers of CD14(high) monocytes increased at 24 h (mean (SD), 5.0 (2.2) vs 7.6 (3.9) x 10(5) cells. ml(-1); p < 0.01) while CD14(low) CD16+ monocytes decreased (0.68 (0.36) vs 0.44 (0.36) x 10(5) cells. ml(-1); p < 0.01). HLA-DR expression was significantly reduced in both subsets by 24 h (mean (SD) fluorescent intensity 440 (310) vs 160 (130) for CD14(high) and 1000 (410) vs 560 (380) for CD14(low) CD16+ subsets; p < 0.01). This reduction of monocyte HLA-DR expression 24 h following lower risk surgery raises questions about the purported clinical utility of this biomarker as an early predictor of postoperative complications. Our results also suggest that surgery induces significant trafficking (i.e. mobilisation, margination and extravasation) of monocyte subsets, and that monocyte HLA-DR depression is the result of a down-regulatory phenomenon (decreased protein expression on each cell) rather than the differential trafficking of monocyte subsets.