title: Elevated plasma concentrations of interferon (IFN)-gamma and the IFN-gamma-inducing cytokines interleukin (IL)-18, IL-12, and IL-15 in severe melioidosis.
abstract: Interferon (IFN)-gamma plays an important role in the pathogenesis of sepsis. Production of IFN-gamma is stimulated by synergistic effects of interleukin (IL)-18, IL-12, and IL-15. To investigate the regulation of IFN-gamma production during severe gram-negative infection, the plasma concentrations of IFN-gamma, IL-18, IL-12, and IL-15 were measured in 83 patients with suspected melioidosis. The diagnosis was confirmed in 62 patients, 31 of whom had blood cultures positive for Burkholderia pseudomallei, of whom 12 died. Compared with healthy controls, patients had elevated levels of IFN-gamma, IL-18, IL-12p40, and IL-15 on admission, with significantly higher levels in blood culture-positive patients, and these levels remained elevated during the 72-h study period. In whole blood stimulated with heat-killed B. pseudomallei, anti-IL-12 had a stronger inhibitory effect than anti-IL-18 and anti-IL-15 on IFN-gamma production. This effect of anti-IL-12 was further enhanced by anti-IL-18. These data suggest that during gram-negative sepsis, IFN-gamma production is controlled at least in part by endogenous IL-18, IL-12, and IL-15.
authors.affiliation: Laboratory of Experimental Internal Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. F.N.Lauw@AMC.UVA.NL
authors.forename: F N
authors.initials: FN
authors.lastname: Lauw
authors.forename: A J
authors.initials: AJ
authors.lastname: Simpson
authors.forename: J M
authors.initials: JM
authors.lastname: Prins
authors.forename: M D
authors.initials: MD
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Kurimoto
authors.forename: S J
authors.initials: SJ
authors.lastname: van Deventer
authors.forename: P
authors.initials: P
authors.lastname: Speelman
authors.forename: W
authors.initials: W
authors.lastname: Chaowagul
authors.forename: N J
authors.initials: NJ
authors.lastname: White
authors.forename: T
authors.initials: T
authors.lastname: van der Poll
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016957:Burkholderia pseudomallei / Q000276:immunology* / Q000302:isolation & purification; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007371:Interferon-gamma / Q000097:blood*; D018664:Interleukin-12 / Q000097:blood; D019409:Interleukin-15 / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D007378:Interleukins / Q000097:blood* / Q000276:immunology; D008297:Male; D008554:Melioidosis / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D008875:Middle Aged; D013845:Thienamycins / Q000627:therapeutic use
chemical_list: D002511:Cephalosporins; D019409:Interleukin-15; D020382:Interleukin-18; D007378:Interleukins; D013845:Thienamycins; D018664:Interleukin-12; D015378:Imipenem; D007371:Interferon-gamma; D002442:Ceftazidime