Monitoring Temporary Immunodepression by Flow Cytometric Measurement of Monocytic HLA-DR Expression: A Multicenter Standardized Study

Immunoparalysis and Adverse Outcomes from Critical Illness

“…Using this technology one can calculate the number of HLA-DR molecules per cell in a way which is reproducible across centers. While clinical investigators are beginning to use this method [27], it does not yet represent the standard approach in this field.…”

Measurement of monocytic HLA-DR (mHLA-DR) expression in patients with severe sepsis and septic shock: assessment of immune organ failure

“…Alternatively, the recovery slope of a diminished mHLA-DR expression seems interesting to investigate [16]. Second, specific (pre)analytical requirements for flow cytometric mHLA-DR analysis apply [17,18]. Both prolonged sample transportation times (more than 4 h) and transportation at room temperature induce a non-specific mHLA-DR increase and may impede precise measurements.…”

“…Both prolonged sample transportation times (more than 4 h) and transportation at room temperature induce a non-specific mHLA-DR increase and may impede precise measurements. Third, flow cytometric mHLA-DR assessment should be performed by using a newly available standardised quantitative test (mHLA-DR in molecules/cell; coefficient of variation: intra-lab 3%, inter-lab 18%) [17]. This may allow interlab data comparison.…”

Is the measurement of monocytes HLA-DR expression useful in patients with sepsis?

“…Inconsistent results rendered comparisons between centers virtually impossible. A kit for the quantification of the mean expression of HLA-DR in circulating monocytes is now commercially available, which has very significantly decreased intra-and inter-assay variability [17]. It requires access to a flow cytometer, however, and is therefore not exactly a simple bedside test.…”