{"id":29219,"date":"2026-02-21T04:55:00","date_gmt":"2026-02-20T20:55:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29219"},"modified":"2026-02-21T06:04:46","modified_gmt":"2026-02-20T22:04:46","slug":"intensive-care-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%84%9f%e6%9f%93%e6%80%a7%e4%bc%91%e5%85%8b%e6%82%a3%e8%80%85%e5%8d%95%e6%a0%b8%e7%bb%86%e8%83%9ehla-dr%e7%9a%84%e8%a1%a8%e8%be%be","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29219","title":{"rendered":"[Intensive Care Med\u53d1\u8868\u8bba\u6587]\uff1a\u611f\u67d3\u6027\u4f11\u514b\u60a3\u8005\u5355\u6838\u7ec6\u80deHLA-DR\u7684\u8868\u8fbe"},"content":{"rendered":"\n

Monocyte HLA-DR expression in septic shock patients: insights from a 20-year real-world cohort of 1023 cases<\/h1>\n\n\n\n

Monneret G, Lafon T, Gossez M,\u00a0et al.<\/em><\/h3>\n\n\n\n

Intensive Care Med<\/em>(2025). https:\/\/doi.org\/10.1007\/s00134-025-08110-w<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Purpose<\/h3>\n\n\n\n

Septic patients simultaneously experience hyperinflammation and immunosuppression, the latter driving ICU-acquired infections, prolonged stays in ICU, and increased mortality. As immunostimulant therapies enter clinical trials, effective stratification is critical to identify patients with the most profound immune dysfunction. Monocyte HLA-DR expression (mHLA-DR) has emerged as the most reliable and actionable biomarker of sepsis-induced immunosuppression.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

We conducted a real-world, 20-year cohort study of 1023 septic shock patients, measuring mHLA-DR by standardized flow cytometry during the first week of ICU admission. Primary outcomes included day-28 and day-90 mortality, and ICU-acquired infections.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Low mHLA-DR (<\u20098000 AB\/C, a threshold already used in phase II trials) was significantly associated with increased mortality and ICU-acquired infections. This association held across static and dynamic measures, multivariate analyses, Kaplan\u2013Meier survival curves, and trajectory clustering (K<\/em>-means).<\/p>\n\n\n\n

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Conclusions<\/h3>\n\n\n\n

This large real-world study confirms that mHLA-DR is a robust enrichment biomarker for identifying the most immunosuppressed septic shock patients at higher risk of adverse outcomes. Importantly, time-course analysis suggests that early immune downregulation may represent a physiological adaptation, while delayed and persistent immunosuppression is associated with worse outcomes. Early single time-point measurements may fail to identify patients who are unlikely to develop delayed immunosuppression. Tracking mHLA-DR trajectories after the initial ICU days is essential for detecting persistent immune dysfunction and selecting patients in case of immunostimulant approaches.<\/p>\n","protected":false},"excerpt":{"rendered":"

Monocyte HLA-DR expression in septic shock patients: in […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29219"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29219"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29219\/revisions"}],"predecessor-version":[{"id":29220,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29219\/revisions\/29220"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29219"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29219"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29219"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}