About: Assessment of immune organ dysfunction in critical illness: utility of innate immune response markers

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Assessment of immune organ dysfunction in critical illness: utility of innate immune response markers
Creator	Meisel, Christian Schefold, Joerg Fux, Michaela Pfortmueller, Carmen
source	PMC
abstract	In critically ill patients, organ dysfunctions are routinely assessed, monitored, and treated. Mounting data show that substantial critical illness-induced changes in the immune system can be observed in most ICU patients and that not only “hyper-inflammation” but also persistence of an anti-inflammatory phenotype (as in sepsis-associated immunosuppression) is associated with increased morbidity and mortality. Despite common perception, changes in functional immunity cannot be adequately assessed by routine inflammatory biomarkers such as C-reactive protein, procalcitonin, or numerical analysis of leukocyte (sub)-counts. Cytokines appear also not suited due to their short half-life and pleiotropy, their unexclusive origin from immune cells, and their potential to undergo antagonization by circulating inactivating molecules. Thus, beyond leukocyte quantification and use of routine biomarkers, direct assessment of immune cell function seems required to characterize the immune systems’ status. This may include determination of, e.g., ex vivo cellular cytokine release, phagocytosis activity, and/or antigen-presenting capacity. In this regard, standardized flow-cytometric assessment of the major histocompatibility-II complex human leukocyte antigen (-D related) (HLA-DR) has gained particular interest. Monocytic HLA-DR (mHLA-DR) controls the interplay between innate and adaptive immunity and may serve as a “global” biomarker of injury-associated immunosuppression, and its decreased expression is associated with adverse clinical outcomes (e.g., secondary infection risk, mortality). Importantly, recent data demonstrate that injury-associated immunosuppression can be reversed—opening up new therapeutic avenues in affected patients. Here we discuss the potential scientific and clinical value of assessment of functional immunity with a focus on monocytes/macrophages and review the current state of knowledge and potential perspectives for affected critically ill patients.
has issue date	2017-10-23(xsd:dateTime)
bibo:doi	10.1186/s40635-017-0163-0
bibo:pmid	29063386
has license	cc-by
sha1sum (hex)	91caf91e581fb6be0754da110e4de41d3650242f
schema:url	https://doi.org/10.1186/s40635-017-0163-0
resource representing a document's title	Assessment of immune organ dysfunction in critical illness: utility of innate immune response markers
has PubMed Central identifier	PMC5653680
has PubMed identifier	29063386
schema:publication	Intensive Care Med Exp
resource representing a document's body	covid:91caf91e581fb6be0754da110e4de41d3650242f#body_text
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