ArticleJournal of clinical medicine2021
Concomitant Assessment of Monocyte HLA-DR Expression and Ex Vivo TNF-α Release as Markers of Adverse Outcome after Various Injuries-Insights from the REALISM Study.
Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed.
- Hallmarks of the multidimensional immune response to trauma in humans.Nature immunology · 2026Review
- Early Identification of a Cytokine-Low Immune Phenotype in Suspected Sepsis Using a Point-of-Care Whole-Blood TNF-α Release Assay.Medical sciences (Basel, Switzerland) · 2026Article
- Article
- Article
- Nano-Enabled Microfluidic Platforms for Functional Immunomonitoring in Pediatric Sepsis.International journal of nanomedicine · 2026Review
- Lipopolysaccharide (LPS)-Induced Tumor Necrosis Factor-Alpha (TNF-ɑ) Levels and Health Care Associated Infection (HAI) in Children with Multi-Organ Dysfunction Syndrome (MODS): Authors' Reply.Indian journal of pediatrics · 2025Article
- Determining potential immunomodulatory drug efficacy in sepsis using ELISpot.Scientific reports · 2025Article
- Immune signatures of sepsis from mild infection to critical illness - a prospective observational study.Frontiers in immunology · 2025Observational
- The immunosuppressive mechanisms induced by sepsis and the corresponding treatment strategies.Frontiers in immunology · 2025Review
- Challenges of monocyte HLA-DR targeted immunomodulation in sepsis-a prospective observational cohort study.Frontiers in immunology · 2025Observational
- Integrated clustering of multiple immune marker trajectories reveals different immunotypes in severely injured patients.Critical care (London, England) · 2024Article
- Article
- Adverse outcomes and an immunosuppressed endotype in septic patients with reduced IFN-γ ELISpot.JCI insight · 2024Article
- Severe thermal and major traumatic injury results in elevated plasma concentrations of total heme that are associated with poor clinical outcomes and systemic immune suppression.Frontiers in immunology · 2024Article
- The impact of trauma relevant concentrations of prostaglandin EFrontiers in immunology · 2024Article
- Assessing sepsis-induced immunosuppression to predict positive blood cultures.Frontiers in immunology · 2024Article
- Prospective flow cytometry analysis of leucocyte subsets in critically ill patients who develop sepsis: a pilot study.Infection · 2023Article
- The spinal cord injury-induced immune deficiency syndrome: results of the SCIentinel study.Brain : a journal of neurology · 2023Article
- The immune suppressive properties of damage associated molecular patterns in the setting of sterile traumatic injury.Frontiers in immunology · 2023Review
- Utility of monocyte HLA-DR and rationale for therapeutic GM-CSF in sepsis immunoparalysis.Frontiers in immunology · 2023Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
Intensive care unit (ICU) patients develop an altered host immune response after severe injuries. This response may evolve towards a state of persistent immunosuppression that is associated with adverse clinical outcomes. The expression of human leukocyte antigen DR on circulating monocytes (mHLA-DR) and ex vivo release of tumor necrosis factor α (TNF-α) by lipopolysaccharide-stimulated whole blood are two related biomarkers offered to characterize this phenomenon. The purpose of this study was to concomitantly evaluate the association between mHLA-DR and TNF-α release and adverse clinical outcome (i.e., death or secondary infection) after severe trauma, sepsis or surgery in a cohort of 353 ICU patients. mHLA-DR and TNF-α release was similarly and significantly reduced in patients whatever the type of injury. Persistent decreases in both markers at days 5-7 (post-admission) were significantly associated with adverse outcomes. Overall, mHLA-DR (measured by flow cytometry) appears to be a more robust and standardized parameter. Each marker can be used individually as a surrogate of immunosuppression, depending on center facilities. Combining these two parameters could be of interest to identify the most immunosuppressed patients presenting with a high risk of worsening. This last aspect deserves further exploration.
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Registered trials
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