Monocytic HLA-DR Expression in Immune Responses of Acute Pancreatitis and COVID-19

Abstract

Acute pancreatitis is a common gastrointestinal disease with increasing incidence worldwide. COVID-19 is a potentially life-threatening contagious disease spread throughout the world, caused by severe acute respiratory syndrome coronavirus 2. More severe forms of both diseases exhibit commonalities with dysregulated immune responses resulting in amplified inflammation and susceptibility to infection. Human leucocyte antigen (HLA)-DR, expressed on antigen-presenting cells, acts as an indicator of immune function. Research advances have highlighted the predictive values of monocytic HLA-DR (mHLA-DR) expression for disease severity and infectious complications in both acute pancreatitis and COVID-19 patients. While the regulatory mechanism of altered mHLA-DR expression remains unclear, HLA-DR−/low monocytic myeloid-derived suppressor cells are potent drivers of immunosuppression and poor outcomes in these diseases. Future studies with mHLA-DR-guided enrollment or targeted immunotherapy are warranted in more severe cases of patients with acute pancreatitis and COVID-19.

Mononuclear cell composition and activation in blood and mucosal tissue of eosinophilic esophagitis

“…Next, a selection of cell activation markers was investigated on the surface of PBMC populations in blood and mucosal tissue in our cohorts. Due to panel and tissue size limitation we focused on investigating expression of CD38 – a receptor and enzyme crucial to immunometabolic pathways and effector functions in most PBMC populations ( 30 ), PD-1 – an immune checkpoint protein ( 31 ), HLA-DR – Human Leukocyte Antigen – DR isotype involved in antigen presentation ( 32 , 33 ), CD69 – general early activation marker ( 34 , 35 ) and CD45RA – a marker of naïve lymphocytes ( 36 ). When we performed multivariate analysis (PCA) of chosen surface activation markers, we observed no clear separation of our groups in blood PBMC populations ( Figure 4A ), in contrast to activation markers on populations in esophageal biopsies that showed good separation and stronger changes between our patient groups ( Figure 4B ).…”

Advances and Challenges in Sepsis Management: Modern Tools and Future Directions

“…Cytokines like granulocyte-macrophage colony-stimulating factor (GM-CSF), which modulates monocyte function by upregulating HLA-DR expression, showed promise in small clinical trials, suggesting potential for sepsis therapy [ 54 ]. However, it should be noted that HLA-DR downregulation correlates with reduced TNF, IL-6, and IL-1β release post- lipopolysaccharide (LPS) stimulation, increasing the risk of adverse events and death in sepsis [ 112 , 113 , 114 ].…”

Monocyte HLA‐DR level on admission predicting in‐hospital mortality rate in exertional heatstroke: A 12‐year retrospective study

“…Besides, platelet (PLT), hemoglobin (Hb), and hematocrit (HCT) levels were lower in nonsurvivors (p < 0.05), indicating possible massive destruction of red blood cells in nonsurvivors. Furthermore, the length of ICU stays and hospital stays in those nonsurvivors (16 [9-20] days and 18 [9-46] days) were both longer than those in survivors (5 [3][4][5][6][7][8] days, p < 0.001 and 11 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] days, p = 0.045). Mean arterial pressure, white blood cell, neutrophil count and percentage, prolonged activated partial thromboplastin time, fibrinogen, serum creatinine, creatine kinase, lymphocyte count and percentage, SIRS and International Society of Thrombosis and Hemostasis score, underlying disease, monocyte count and percentage, and RM between survivors and nonsurvivors were not significantly different.…”

“…The human leukocyte antigen(HLA)‐DR, a trustworthy marker of monocyte activating, 7 can assist monocytes in presenting antigen signals to T cells to initiate immune reaction, which is crucial for host defense, immunological homeostasis, and immune surveillance 8 . Low monocyte HLA‐DR (mHLA‐DR) levels have been observed in critically ill individuals with severe burns, 9 hepatitis, 10 pancreatitis 11 and trauma, 12 as well as sepsis particularly 13 . Current research has verified that the expression of mHLA‐DR below 30% indicates that the individual is immunologically paralyzed and vulnerable to secondary infection, MODS, and even death 14,15 …”