Decreased Monocyte HLA-DR Expression in Patients with Sepsis and Acute Kidney Injury

• Published in: Medicina (Kaunas, Lithuania) Vol. 58; no. 9; p. 1198
• Main Authors: Wu, Huang-Pin, Chuang, Li-Pang, Liu, Pi-Hua, Chu, Chien-Ming, Yu, Chung-Chieh, Lin, Shih-Wei, Kao, Kuo-Chin, Li, Li-Fu, Chuang, Duen-Yau
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.09.2022; MDPI
• Subjects: acute kidney injury; Age; Antigens; Blood pressure; Chronic kidney failure; Creatinine; Health aspects; Hemodialysis; Histocompatibility antigens; HLA histocompatibility antigens; HLA-DR; Hypotension; Infections; Kidneys; Ligands; Measurement; monocyte; Monocytes; Mortality; Plasma; Risk factors; Sepsis; Statistical analysis; Taiwan; United States > US
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina58091198

Background and objectives: Acute kidney injury (AKI) is common in critically ill patients, especially those with sepsis. Persistently low human leukocyte antigen (HLA)-DR expression in monocytes reflects the decreased function of antigen-presenting cells, contributing to poor outcomes in sepsis. This study aimed to establish an association between AKI and HLA-DR expression in monocytes of patients with sepsis. Materials and Methods: We detected HLA-DR expression in monocytes and measured plasma levels of S100A12, high-mobility group box 1 (HMGB1), advanced glycation end products (AGE), and soluble receptor for AGE (sRAGE) from septic patients and healthy controls. Results: HLA-DR expression in monocytes was decreased in patients with AKI than in those without AKI (29.8 ± 5.0% vs. 53.1 ± 5.8%, p = 0.005). Compared with AKI patients, the mean monocyte HLA-DR expression in patients with end-stage renal disease was increased without statistical significance. There were no differences in the AGE/sRAGE ratio and plasma levels of S100A12, HMGB1, AGE, and sRAGE between patients with and without AKI. Conclusions: Compared with septic patients without AKI, patients with AKI had significantly lower HLA-DR expression in monocytes. The role of hemodialysis in monocyte HLA-DR expression needs further studies to explore.