title: Change in the ratio of interleukin-6 to interleukin-10 predicts a poor outcome in patients with systemic inflammatory response syndrome.
abstract: OBJECTIVE
  To examine whether changes in interleukin (IL)-6 and IL-10 concentrations in patients with systemic inflammatory response syndrome (SIRS) can predict a poor outcome.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Emergency and intensive care unit of a medical school hospital.
  
  
  METHODS
  Twenty-five patients who fulfilled the criteria for SIRS.
  
  
  METHODS
  Blood samples were collected for cytokine determinations.
  
  
  RESULTS
  IL-6 and IL-10 concentrations were measured by enzyme-linked immunosorbent assay in plasma samples. Blood samples were obtained at 0, 1, 2, and 4 days from patients who fulfilled the criteria for SIRS. Of 25 patients, 19 survived and the other six patients died of multiple organ failure. Although IL-6 and IL-10 concentrations in survivors decreased gradually from 186.1 +/- 34.4 to 93.6 +/- 18.9 (SEM) pg/mL (p < .05) and from 77.4 +/- 21.2 to 32.0 +/- 11.8 pg/mL (p < .05), IL-6 concentrations in nonsurvivors did not. Although the ratio of IL-6 to IL-10 in survivors was almost stable, the ratio in nonsurvivors increased from 5.5 +/- 3.1 to 18.7 +/- 2.8 (p < .05). Multivariate analysis showed that when heart rate, mean arterial pressure, IL-6, IL-10, and the ratio of IL-6 to IL-10 were taken into account, there only remained a relationship between the ratio of IL-6 to IL-10 and outcome.
  
  
  CONCLUSIONS
  In nonsurvivors, IL-6 concentrations did not decrease, IL-10 concentration decreased, and the ratio of IL-6 to IL-10 increased. An increase in the ratio of IL-6 to IL-10 indicated a correlation with a poor outcome.
authors.affiliation: Department of Emergency and Critical Care Medicine, Tama-nagayama Hospital, Nippon Medical School, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Koido
authors.forename: J
authors.initials: J
authors.lastname: Aiboshi
authors.forename: T
authors.initials: T
authors.lastname: Yamashita
authors.forename: S
authors.initials: S
authors.lastname: Suzaki
authors.forename: A
authors.initials: A
authors.lastname: Kurokawa
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000401:mortality
chemical_list: D015850:Interleukin-6; D016753:Interleukin-10