Department of Surgical Diseases, University Hospital "Prof. Dr. Stoyan Kirkovich," Stara Zagora, Bulgaria.
Department of Immunology, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria.
Surg Infect (Larchmt). 2020 Mar;21(2):77-80. doi: 10.1089/sur.2019.050. Epub 2019 Sep 4.
Complicated intra-abdominal infections (cIAIs) are still associated with high morbidity and mortality levels. Early prognostic evaluation is a great challenge, and a serious amount of resources have been used to find the perfect mortality predictor. Monocyte human leukocyte antigen-DR (mHLA-DR) expression has been studied as a biomarker in patients with sepsis and other infections. Our aim was to evaluate the potential prognostic performance of mHLA-DR in patients with cIAIs. We performed an electronic search of Google Scholar and PubMed databases for articles published before January 2019. The search terms were "HLA-DR," "monocyte HLA-DR," "intra-abdominal infections," "sepsis," "outcome," and "mortality." A total of 12 studies with 761 patients met our inclusion criteria. In 10 studies, poor outcome was predicted by lower mHLA-DR expression, and two studies showed no prognostic value. This review found association between lower mHLA-DR expression and mortality. We concluded that mHLA-DR could be a reliable and meaningful predictor of poor outcome in patients with cIAIs. Nevertheless, more large prospective studies with surgical patients exclusively are needed before using this biomarker in a clinical setting.
复杂的腹腔内感染（cIAI）仍然与高发病率和死亡率有关。早期预后评估是一个巨大的挑战，已经投入了大量资源来寻找完美的死亡率预测因子。单核细胞人类白细胞抗原-DR（mHLA-DR）的表达已作为脓毒症和其他感染患者的生物标志物进行了研究。我们的目的是评估 mHLA-DR 在 cIAI 患者中的潜在预后表现。
我们在 Google Scholar 和 PubMed 数据库中进行了电子搜索，以查找 2019 年 1 月之前发表的文章。搜索词为“HLA-DR”、“单核细胞 HLA-DR”、“腹腔内感染”、“脓毒症”、“结果”和“死亡率”。共有 12 项符合纳入标准的研究，涉及 761 名患者。在 10 项研究中，较低的 mHLA-DR 表达预示着不良预后，而两项研究显示无预后价值。
这项综述发现 mHLA-DR 表达降低与死亡率之间存在关联。我们得出结论，mHLA-DR 可能是 cIAI 患者不良预后的可靠且有意义的预测因子。然而，在临床环境中使用这种生物标志物之前，还需要更多针对手术患者的大型前瞻性研究。
