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Vol. 152. Issue 9.
Pages 346-349 (May 2019)
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Vol. 152. Issue 9.
Pages 346-349 (May 2019)
Brief report
DOI: 10.1016/j.medcle.2019.02.014
Enhanced HLA-DR expression on T-lymphocytes from patients in early stages of non-surgical sepsis
Elevada expresión de HLA-DR en linfocitos T de pacientes en fases tempranas de sepsis no quirúrgica
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Esther Fernández-Grandea,
Corresponding author
e.fernandezgrande@gmail.com

Corresponding author.
, Carmen María Cabrerac, Blanca Gonzáleza, Carolina Varelad, José Miguel Urraa,b
a Immunology, Hospital General Universitario de Ciudad Real, Spain
b Medicine Faculty-Ciudad Real, Universidad de Castilla La Mancha, Spain
c Immunology, Hospital Regional Universitario Carlos Haya, Málaga, Spain
d Preventive Medicine, Hospital General Universitario de Ciudad Real, Spain
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Table 1. Clinical and demographic features of the septic patients (N=26) affected of primary bacteraemia.
Abstract
Introduction

Early detection of sepsis is a critical step to improve patient's survival and cellular markers effective diagnosis tools. The aim of this work was to evaluate HLA-DR expression on peripheral T-lymphocytes (CD3+), a marker associate to T-cell activation, as an early sepsis detection tool.

Patients and methods

A cross-sectional study was conducted in twenty-six patients with confirmed sepsis by blood culture, eighteen healthy individuals and four patients with systemic inflammatory response syndrome. The analysis of the HLA-DR expression was carried by flow cytometry.

Results

The patients with confirmed sepsis had significantly higher percentage of CD3+/HLA-DR+ lymphocytes compared with both, patients with SIRS (20.37±9.42 vs. 8.7±2.9; p<0.005) and healthy individuals (20.37±9.42 vs. 6.58±3.89; p<0.005). Moreover, the average amount of HLA-DR expressed was higher when caused by gram-positive than by gram-negative bacterias (216.61±131.35 vs. 135.05±31.82; p=0.041). A ROC curve analysis showed the utility of HLA-DR expression on T-cells to identify patients with sepsis.

Discussion

Our results suggest that surface expression of HLA-DR on T-lymphocytes could be an early marker for the presence of sepsis in non-surgical septic patients.

Keywords:
Sepsis
HLA-DR
T-lymphocytes
Resumen
Introducción

La detección temprana de la sepsis es un paso crítico para mejorar la supervivencia del paciente. Nuestro objetivo fue evaluar la expresión de HLA-DR en linfocitos T periféricos (CD3+), marcador asociado a la activación de células T, como herramienta de detección temprana de la sepsis.

Pacientes y métodos

Se realizó un estudio en 26 pacientes con sepsis confirmada, 18 sanos y 4 con síndrome de respuesta inflamatoria sistémica(SIRS). La expresión de HLA-DR se midió por citometría de flujo.

Resultados

Los pacientes con sepsis tenían un porcentaje significativamente mayor de linfocitos CD3+/HLA-DR+ en comparación con los otros grupos, pacientes con SIRS (20,37±9,42 vs. 8,7±2,9; p<0,005) y sanos (20,37±9,42 vs. 6,58±3,89; p<0,005). La cantidad media de HLA-DR fue mayor cuando la sepsis estaba causada por bacterias gram-positivas que por gram-negativas (216,61±131,35 vs. 135,05±31,82; p=0,041). El análisis mediante curva ROC mostró la utilidad de la expresión de HLA-DR en células T para identificar pacientes con sepsis.

Discusión

Nuestros resultados sugieren que la expresión de HLA-DR en linfocitos T podría ser un marcador temprano de sepsis en pacientes sépticos no quirúrgicos.

Palabras clave:
Sepsis
HLA-DR
Linfocitos T

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