Zouiouich Mehdi, Gossez Morgane, Venet Fabienne, Rimmelé Thomas, Monneret Guillaume
Hospices Civils de Lyon, Immunology Laboratory, E. Herriot Hospital, 69003, Lyon, France.
EA7426 "Pathophysiology of injury-induced immunosuppression" (University Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), 69008, Lyon, France.
Intensive Care Med Exp. 2017 Aug 30;5(1):39. doi: 10.1186/s40635-017-0156-z.
In various ICU conditions, measurement of diminished expression of human leukocyte antigen-DR on circulating monocytes (mHLA-DR) by flow cytometry appears to be a reliable marker of acquired immunosuppression. Low mHLA-DR is associated with an increased risk of nosocomial infections and mortality. Nevertheless, its use remains somewhat limited and has not been adopted in common medical practice. The main drawback of mHLA-DR measurement is likely related to the use of flow cytometry that is not accessible everywhere on a 24/7 basis. Recently, the Accellix system, a fully automated table top cytometer, was developed for use at bedside or emergency labs.
The objective was to assess the performance of the Accellix (beta site evaluation including repeatability and method comparison with reference protocol) for the measurement of mHLA-DR expression.
Accellix repeatability at low and high expression levels of mHLA-DR was < 10% (i.e., within the range of acceptability for clinical flow cytometry). In comparison study including 139 blood samples (67 septic shock patients and 17 healthy volunteers), Pearson's correlation parameters (r ) ranged from 0.71 to 0.97 (p < 0.001). Intra-class correlation coefficient was 0.92.
This fully automated table top cytometer appears to be a suitable tool for ICU patient monitoring and on-going clinical trials as there is no sample preparation and no need for specific skills in flow cytometry. Upon validation in a larger cohort study to reinforce reliability, Accellix could represent a major step to make flow cytometry accessible to clinicians by placing the instrument inside intensive care units or emergency laboratories.
在各种重症监护病房（ICU）环境中，通过流式细胞术测量循环单核细胞上人类白细胞抗原-DR（mHLA-DR）表达降低似乎是获得性免疫抑制的可靠标志物。低mHLA-DR与医院感染风险增加和死亡率相关。然而，其应用仍然有些受限，尚未在普通医疗实践中采用。mHLA-DR测量的主要缺点可能与流式细胞术的使用有关，流式细胞术并非在任何地方都能随时使用。最近，Accellix系统，一种全自动台式细胞仪，被开发用于床边或急诊实验室。
目的是评估Accellix系统（包括重复性和与参考方案的方法比较的β期现场评估）用于测量mHLA-DR表达的性能。
Accellix在mHLA-DR低表达和高表达水平下的重复性<10%（即在临床流式细胞术的可接受范围内）。在包括139份血样（67例感染性休克患者和17名健康志愿者）的比较研究中，皮尔逊相关参数（r）范围为0.71至0.97（p<0.001）。组内相关系数为0.92。
这种全自动台式细胞仪似乎是ICU患者监测和正在进行的临床试验的合适工具，因为无需样品制备，也不需要流式细胞术的特定技能。在更大规模队列研究中进行验证以增强可靠性后，Accellix可能代表了通过将仪器放置在重症监护病房或急诊实验室中，使临床医生能够使用流式细胞术的重要一步。
