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Low monocyte HLA-DR expression as an indicator of immunodepression in very low birth weight infants.
Palojärvi, Anniina; Petäjä, Jari; Siitonen, Sanna; Janér, Cecilia; Andersson, Sture.
Afiliación
  • Palojärvi A; Department of Neonatology, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. anniina.palojarvi@gmail.com
Pediatr Res ; 73(4 Pt 1): 469-75, 2013 Apr.
Article en En | MEDLINE | ID: mdl-23269117
BACKGROUND: As a protective response to an inflammatory stimulus, the antigen-presenting molecules (human leukocyte antigen-DR (HLA-DR)) on monocytes are downregulated. If severe, the response may lead to immunodepression or immunoparalysis, associated with an increased rate of morbidity and mortality in adults. In very low birth weight (VLBW) infants, birth and intensive care present major immunological challenges. METHODS: We measured monocyte HLA-DR expression by flow cytometry and determined 13 plasma cytokines in 56 VLBW infants (gestational age (GA): 23.7-31.8 wk) and 25 controls (GA: 34.1-41.4 wk). RESULTS: HLA-DR expression decreased postnatally both in VLBW and in control infants. In VLBW infants, GA and respiratory distress syndrome (RDS) both showed associations with HLA-DR nadir on day 3, when 45% of them met the criteria of immunodepression. HLA-DR expression was lower in those infants subsequently developing infection (74 vs. 49% (day 3) and 85 vs. 68% (day 7); both P = 0.002). Interleukin (IL)-6 on day 1 was a predictor of the HLA-DR nadir. CONCLUSION: VLBW infants are in a state of immunodepression postnatally. This immunodepression correlated with GA and was a predisposing factor for late infections. The downregulation of HLA-DR during RDS probably indicates an RDS-induced antigen load on the immune system.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recien Nacido Prematuro / Monocitos / Antígenos HLA-DR / Recién Nacido de muy Bajo Peso / Recien Nacido Extremadamente Prematuro / Tolerancia Inmunológica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Res Año: 2013 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos
Texto completo
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Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recien Nacido Prematuro / Monocitos / Antígenos HLA-DR / Recién Nacido de muy Bajo Peso / Recien Nacido Extremadamente Prematuro / Tolerancia Inmunológica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Res Año: 2013 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos