Down regulation of monocyte antigen presentation in critical illness and septic shock

Janice Manjuck, Dhanonjoy Saha, Mark Astiz, Jane Eales, Eric Rackow

Research output: Contribution to journalArticlepeer-review


Introduction: Monocyte HLA-DR expression is decreased in sepsis. However, antigen presentation and the expression of other costimulatory molecules have not been studied in this setting. Methods: We examined antigen presentation (Antig P) using in vitro lymphocyte response to tuberculin toxoid. Lymphocyte incorporation of 5-bromo-2-deoxyuridine was measured by ELISA as % absorbance (% abs). Ten normal controls, 10 critically ill non-septic patients (CINS), 15 patients with septic shock (SS) were studied. Monocyte (M) HLA-DR and CD-86 receptors was evaluated by flow cytometry as were lymphocyte (L) expression of CD28 and CTLA. Flow cytometry data are presented as % expression. All data are presented as mean ± SE.*P<0.5 vs control. + p<005 vs CINS. Results: C CINS SS AGE(yrs) 57±7 65±7 68±6 APACHE III - 51±4 88±12+ Antig P (% abs) 989±313 235±65*111±55*M-HLA-DR (%) 81±5 57±11 47±6*M-CD-86(%) 69±5 34±8*22±3.6*L-CTLA (%) 0.1±0.1 0.3±0.2 1±0.4*L-CD28 (%) 62±3 56±5 35±7*+ Conclusion: Antigen presentation is decreased in SS and critical illness. The decrease appears greater in SS and is associated with significant decreases in HLA-DR expression and the expression of other monocyte (CD-86) and lymphocyte (CD28) costimulatory molecules. Increased expression of the negative lymphocyte signal receptor (CTLA) is also present in SS and may contribute to decreased antigen presentation.

Original languageEnglish (US)
Pages (from-to)A47
JournalCritical care medicine
Issue number1 SUPPL.
StatePublished - 1999
Externally publishedYes

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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