Human leukocyte antigen DR surface expression on CD14+ monocytes during adverse events after hematopoietic stem cell transplantation
- 206 Downloads
The human leukocyte antigen DR surface expression on CD14+ monocytes reflects the degree to which these cells have been activated. Given the central role monocytes and macrophages play in the immune system, a decreased human leukocyte antigen DR expression on CD14+ monocytes results in a hallmark of altered immune status during systemic inflammatory response syndrome. We hypothesize that human leukocyte antigen DR expression might be similarly altered after hematopoietic stem cell transplantation and during post-transplant complications. Using flow cytometry, this study investigates the human leukocyte antigen DR surface expression of CD14+ monocytes in 30 pediatric and young adult patients up to 1 year after hematopoietic stem cell transplantation. Normal values were derived from a control group of healthy children, adolescents, and young adults. Human leukocyte antigen DR expression decreased significantly prior and during bacterial infection or sepsis. By contrast, human leukocyte antigen DR expression levels were elevated before and at the time of viremia. Human leukocyte antigen DR expression was also elevated during acute graft-versus-host disease. In contrast, the expression was reduced when patients had hepatic veno-occlusive disease. A significant decrease of human leukocyte antigen DR expression was associated with a relapse of the underlying disease and before death. Human leukocyte antigen DR expression on CD14+ monocytes appears to be a promising parameter that might allow identification of patients at risk after hematopoietic stem cell transplantation.
KeywordsHuman leukocyte antigen DR expression CD14+ monocytes Hematopoietic stem cell transplantation Pediatric patients
Conflict of interest
The authors declare that they have no conflict of interests.
- 1.Almyroudis NG, Fuller A, Jakubowski A, Sepkowitz K, Jaffe D, Small TN, Kiehn TE, Pamer E, Papanicolaou GA (2005) Pre- and post-engraftment bloodstream infection rates and associated mortality in allogeneic hematopoietic stem cell transplant recipients. Transplant infect dis : off j Transplant Soc 7(1):11–17. doi: 10.1111/j.1399-3062.2005.00088.x CrossRefGoogle Scholar
- 4.Takatsuka H, Takemoto Y, Yamada S, Wada H, Tamura S, Fujimori Y, Okamoto T, Suehiro A, Kanamaru A, Kakishita E (2000) Complications after bone marrow transplantation are manifestations of systemic inflammatory response syndrome. Bone Marrow Transplant 26(4):419–426. doi: 10.1038/sj.bmt.1702517 PubMedCrossRefGoogle Scholar
- 5.Docke WD, Hoflich C, Davis KA, Rottgers K, Meisel C, Kiefer P, Weber SU, Hedwig-Geissing M, Kreuzfelder E, Tschentscher P, Nebe T, Engel A, Monneret G, Spittler A, Schmolke K, Reinke P, Volk HD, Kunz D (2005) Monitoring temporary immunodepression by flow cytometric measurement of monocytic HLA-DR expression: a multicenter standardized study. Clin Chem 51(12):2341–2347. doi: 10.1373/clinchem.2005.052639 PubMedCrossRefGoogle Scholar
- 7.Monneret G, Finck ME, Venet F, Debard AL, Bohe J, Bienvenu J, Lepape A (2004) The anti-inflammatory response dominates after septic shock: association of low monocyte HLA-DR expression and high interleukin-10 concentration. Immunol Lett 95(2):193–198. doi: 10.1016/j.imlet.2004.07.009 PubMedCrossRefGoogle Scholar
- 11.Kanakoudi-Tsakalidou F, Debonera F, Drossou-Agakidou V, Sarafidis K, Tzimouli V, Taparkou A, Kremenopoulos G (2001) Flow cytometric measurement of HLA-DR expression on circulating monocytes in healthy and sick neonates using monocyte negative selection. Clin Exp Immunol 123(3):402–407PubMedCentralPubMedCrossRefGoogle Scholar
- 13.Ono S, Tsujimoto H, Matsumoto A, Ikuta S, Kinoshita M, Mochizuki H (2004) Modulation of human leukocyte antigen-DR on monocytes and CD16 on granulocytes in patients with septic shock using hemoperfusion with polymyxin B-immobilized fiber. Am J Surg 188(2):150–156. doi: 10.1016/j.amjsurg.2003.12.067 PubMedCrossRefGoogle Scholar
- 14.Goldstein B, Giroir B, Randolph A (2005) International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr crit care med : j Soc Crit Care Med World Fed Pediatr Intensiv Crit Care Soc 6(1):2–8. doi: 10.1097/01.pcc.0000149131.72248.e6 CrossRefGoogle Scholar
- 20.Xun CQ, Thompson JS, Jennings CD, Brown SA, Widmer MB (1994) Effect of total body irradiation, busulfan-cyclophosphamide, or cyclophosphamide conditioning on inflammatory cytokine release and development of acute and chronic graft-versus-host disease in H-2-incompatible transplanted SCID mice. Blood 83(8):2360–2367PubMedGoogle Scholar
- 26.Fowler DH, Foley J, Whit-Shan Hou J, Odom J, Castro K, Steinberg SM, Gea-Banacloche J, Kasten-Sportes C, Gress RE, Bishop MR (2004) Clinical “cytokine storm” as revealed by monocyte intracellular flow cytometry: correlation of tumor necrosis factor alpha with severe gut graft-versus-host disease. Clin gastroenterol hepatol : off clin pract j Am Gastroentero Assoc 2(3):237–245CrossRefGoogle Scholar