title: High levels of interleukin 10 in serum are associated with fatality in meningococcal disease.
abstract: Interleukin 10 (IL-10) suppresses the production of proinflammatory cytokines in vitro and in murine models of endotoxemia and has been suggested as a candidate for treatment of bacterial septicemia. To investigate the role of IL-10 in meningococcal disease, a sandwich IL-10 enzyme-amplified sensitivity immunoassay was used to quantitate IL-10 in serum and cerebrospinal fluid samples from 41 patients with meningococcal bacteremia or meningitis with or without septic shock. High levels of IL-10 were demonstrated in sera from patients with meningococcal septic shock (mean, 21,221 pg/ml; range, 25 to 64,500 pg/ml). All cases involving fatalities had IL-10 levels in serum of > or = 1,000 pg/ml (mean, 23,058 pg/ml; range, 1,000 to 64,500 pg/ml). Patients with meningococcal meningitis without septic shock had comparably low concentrations of IL-10 in serum (mean, 119 pg/ml; range, 0 to 1,050 pg/ml) but exhibited compartmentalized release of IL-10 in cerebrospinal fluid. Concentrations of IL-10 in serum were positively correlated with the previously reported concentrations of tumor necrosis factor alpha, IL-6, and IL-8 in serum in the same patients. We conclude that IL-10 is extensively activated along with the proinflammatory cytokines during the initial phase of meningococcal septic shock and that IL-10 is associated with fatality in meningococcal disease.
authors.affiliation: Medical Department B, University of Bergen, Norway.
authors.forename: A K
authors.initials: AK
authors.lastname: Lehmann
authors.forename: A
authors.initials: A
authors.lastname: Halstensen
authors.forename: S
authors.initials: S
authors.lastname: Sørnes
authors.forename: O
authors.initials: O
authors.lastname: Røkke
authors.forename: A
authors.initials: A
authors.lastname: Waage
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D016753:Interleukin-10 / Q000097:blood* / Q000134:cerebrospinal fluid; D015850:Interleukin-6 / Q000032:analysis; D008297:Male; D008589:Meningococcal Infections / Q000378:metabolism*; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10