Monocyte HLA-DR expression in septic shock patients: insights from a 20-year real-world cohort of 1023 cases.

ABSTRACT:

Purpose

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.

Methods

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.

Results

Low mHLA-DR (< 8000 AB/C, a threshold alr

SUBMITTER: Monneret G 

PROVIDER: S-EPMC12504386 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature