Why Early mHLA-DR Fails and Dynamic Monitoring is Key to Immunosuppression in Septic Shock

link.springer.com October 6, 2025

This 20-year study of 1,023 septic shock patients confirms that the immune marker mHLA-DR is a robust biomarker for identifying the most immunosuppressed patients who face a higher risk of death and ICU-acquired infections.

The crucial finding is that timing matters:

Early vs. Delayed Immunosuppression: The research suggests that an initial, early drop in mHLA-DR may be a normal biological response or adaptation. However, delayed and persistent low mHLA-DR (specifically below the threshold of <8000 AB/C) is the critical indicator that predicts worse outcomes. The Need for Tracking: A single measurement taken early in the ICU stay is insufficient. Tracking the mHLA-DR trajectory over the first week is essential to accurately detect prolonged immune dysfunction. This dynamic monitoring is vital for selecting the right patients for potential immunostimulant therapies.