Dynamic monitoring of monocyte HLA-DR expression for the diagnosis, prognosis, and prediction of sepsis.

Sepsis, an under-recognized health problem, is a major cause of death.  More than 750,000 individuals develop sepsis annually, of whom 215,000 die of the disease. Clinical and experimental evidence indicates that patients with sepsis present with rapid impairment of immune function; biomarkers are therefore needed to enable early detection of this condition. Reduced monocyte human leukocyte antigen-DR (HLA-DR) expression, which is measured by flow cytometry, is currently the most popular biomarker for sepsis detection. In addition, the determination of HLA-DR expression provides valuable information in terms of predicting mortality and risk of secondary infections. HLA-DR levels have been shown to be inversely correlated with the severity of sepsis and immune dysfunction. In this review, we provide an overview of the association between sepsis and HLA-DR expression in terms of the predictive value of the latter in sepsis.