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We read through with interest the current report by Gogos and colleagues [1]. Even though the rationale for his or her examine is superb, we'd want to comment on technical problems that could have influenced the outcomes.As stated, a time limit of eight hours in between sample drawing GABA Receptor inhibitor Available for Beginners and staining at a central laboratory was specified [1]. Unfortunately, info pertaining to transport ailments is missing (normal time, temperature). This looks significant due to the fact monocytic HLA-DR expression (mHLA-DR) increases artificially over time [2,3]. Consequently, recommendations suggest that sample staining for mHLA-DR should take place inside of four hours [2,3]. Although the authors aimed to address the impact of transportation, they inappropriately used samples presenting with already near-maximal mHLA-DR values (> 90%) prior to storage.

We for that reason presume that mHLA-DR outcomes may very well be falsely elevated resulting from prolonged transportation times. Additionally, mHLA-DR modulation for the duration of sepsis takes days and consecutive measurements are demanded [4]. Assessment of one particular early sample (inside of the initial 24 hrs) is most likely inappropriate to investigate the impact of infection on mHLA-DR. Biperiden HCl Available for First-timers Similarly, apoptosis staining should not be performed immediately after 8 hrs and experts' suggestions highlight the want for committed protocols on fresh cells [5].We are convinced that effective potential trials in sepsis will depend on our capability to accurately assess immune responses. In that sense, flow cytometry multicentric clinical studies are vital. This kind of trials ought to be carried out in standardized environments in accordance with precise (pre)analytical prerequisites.

Otherwise, effects may be misinterpreted and could impede promising new avenues in long term care of septic individuals.AbbreviationsICU: intensive care unit; mHLA-DR: VX-809 Intended for Beginners monocytic human leukocyte antigen DR-1.Competing interestsThe authors declare they have no competing interests.NotesSee related research by Gogos et al., http://ccforum.com/content/14/3/R96, associated commentary by Cavaillon and Adib-Conquy, http://ccforum.com/content/14/3/167 and linked letter by L��pez-Collazo et al., http://ccforum.com/content/14/4/435