HLA-DR Expression on Monocytes and Systemic Inflammation in Patients with Ruptured Abdominal Aortic Aneurysms

Overview

Journal Crit Care

Specialty Critical Care

Date 2006 Aug 11

PMID 16899122

Citations 12

Authors

Jan Willem W Haveman

Aad P van den Berg

Eric L G Verhoeven

Maarten W N Nijsten

Jan J A M van den Dungen

Hauw T The

Jan H Zwaveling

Affiliations

Soon will be listed here.

Abstract

Introduction: Mortality from ruptured abdominal aortic aneurysms (RAAA) remains high. Severe systemic inflammation, leading to multi-organ failure, often occurs in these patients. In this study we describe the level of HLA-DR expression in a consecutive group of patients following surgery for RAAA and compare results between survivors and non-survivors. A similar comparison is made for IL-6, IL-10 levels and SOFA-scores.

Methods: This is a prospective observational study. Patients with RAAA were prospectively analyzed. Blood samples were collected on day 1, 3, 5, 7, 10 and 14. The fraction of CD-14 positive monocytes expressing HLA-DR was measured by flow-cytometry. Interleukin-6 and interleukin-10 levels were measured by ELISA.

Results: Thirty patients with a median age of 70 years were included. There were 27 (90%) men. Six patients died from multiple organ failure, all other patients survived. The Sequential Organ Failure Assessment (SOFA) scores were significantly higher in non-survivors on day 1 through 14. HLA-DR expression on monocytes was significantly lower on day 3, 5, 7, 10 and 14 in non-survivors. Interleukin-6 and IL-10 levels were significantly higher in non-survivors on day 1 and day 1 and 3 respectively.

Conclusions: HLA-DR expression on monocytes was decreased, especially in non-survivors. All patients with RAAA displayed a severe inflammatory and anti-inflammatory response with an increased production of IL-6 and IL-10. Poor outcome is associated with high levels of IL-6 and IL-10 and a high SOFA score in the first three days after surgery, while low levels of HLA-DR expression are observed from day three after RAAA repair.

Citing Articles

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