Tumour necrosis factor-alpha and interleukin-10 production in septic patients and the regulatory effect of plasma.
OBJECTIVE
To investigate the capacity of patients' whole blood to produce proinflammatory and antiinflammatory cytokines in severe sepsis and to relate abnormalities to the effect of the patients' plasma on cytokine production in healthy donor blood.


METHODS
Open, prospective clinical study.


METHODS
Teaching hospital, Germany.


METHODS
Ten patients in the surgical intensive care unit with shock and a systemic inflammatory response syndrome (SIRS), a mean APACHE II score of 27, and dysfunction of at least two organ systems at the time of investigation, resulting in 70% mortality.


METHODS
Tumour necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) concentrations.


RESULTS
TNF-alpha and IL-10 production of the whole blood in response to lipopolysaccharide (LPS) was reduced from 2000 pg/ml to 90 pg/ml and from 9163 pg/ml to 622 pg/ml, respectively (p < 0.01). When the plasma of these septic patients was added to the whole blood cells of healthy donors TNF-alpha production decreased by 38% to 1238 pg/ml (p < 0.01) and IL-10 production by 36% to 5857 pg/ml (p = 0.03).


CONCLUSIONS
The effect of plasma from septic patients on the cytokine production in healthy donor blood cells paralleled the decreased production of proinflammatory TNF-alpha and antiinflammatory IL-10 in the whole blood of septic patients. Efforts to modulate cytokine production in septic patients therefore need to take account of the signals from the plasma as well as the functional capacity of the cells.
Haupt
W
W
Department of Surgery, University of Erlangen-Nuremberg, Germany.
Zirngibl
H
H
Stehr
A
A
Riese
J
J
Holzheimer
R G
RG
Hohenberger
W
W
D018806:APACHE; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis*; D009102:Multiple Organ Failure / Q000097:blood; D011446:Prospective Studies; D012772:Shock, Septic / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10