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

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.

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Publication Details

Journal
Intensive Care Medicine
Published
2025-09-23
DOI
https://doi.org/10.1007/s00134-025-08110-w
Citations
10
Primary Topic
Sepsis Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
13.54

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article

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

Laurent Argaud, Guillaume Monneret, Thomas Lafon, Morgane Gossez et al.
10 citations
Intensive Care Medicine
Sepsis Diagnosis and Treatment
13.54
article

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

Laurent Argaud, Guillaume Monneret, Thomas Lafon, Morgane Gossez, Bernard Allaouchiche, Martin Cour, Arnaud Friggeri, Bruno Evrard, Alain Lepape, Maxime Bodinier, Fabienne Venet, Anne‐Claire Lukaszewicz, Thomas Rimmelé
article en
10 citations

Abstract

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.

Intensive Care MedicineVol. 51(10)
Université Claude Bernard Lyon 1 (FR), École Normale Supérieure de Lyon (FR), Institut Mérieux (France) (FR), Centre National de la Recherche Scientifique (FR), Inserm (FR), Lyon College (US), Hospices Civils de Lyon (FR), Hôpital Lyon Sud (FR), Centre International de Recherche en Infectiologie (FR), Université de Limoges (FR)
Hospices Civils de Lyon
Openalex Percentile: Top 1%
Sepsis Diagnosis and Treatment
13.54
DOIOpen Access PDFOpenAlex
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