Decreased cytokine expression in peripheral blood leukocytes of patients with severe sepsis.
BACKGROUND
High levels of tumor necrosis factor (TNF) alpha messenger RNAs and interleukin (IL) 8 have been reported in leukocytes of patients with sepsis.


OBJECTIVE
Assessment of leukocyte intracytoplasmic levels of proinflammatory and anti-inflammatory cytokines might be clinically more relevant to determine prognosis in patients with severe sepsis.


METHODS
Cohort study.


METHODS
Surgical intensive care units of a university hospital.


METHODS
Leukocyte suspensions obtained from 16 patients, 6 during early sepsis or septic shock and 10 during late sepsis or septic shock, were incubated with anti-CD14 and anti-CD2 or anti-CD3 monoclonal antibodies and then with intracytoplasmic anticytokine antibodies staining for interferon-gamma, TNF-alpha, IL-2, IL-6, IL-8, IL-10, and IL-12 and analyzed with a flow cytometer.


METHODS
Mann-Whitney test and Spearman correlation test were used in statistical evaluations according to the 28-day all-cause mortality rates and multiple organ dysfunction and sepsis-related organ failure assessment scores.


RESULTS
Higher serum IL-6, IL-8, C-reactive protein, and procalcitonin levels were found in patients with high multiple organ dysfunction and sepsis-related organ failure assessment scores (greater than or equal to the median values [8 and 11, respectively]), in contrast to decreased T-lymphocyte-associated IL-6 and TNF-alpha and monocyte-associated IL-10 and IL-12 proportions. Furthermore, in 28-day all-cause mortality analysis, there were higher levels of C-reactive protein and procalcitonin in nonsurvivors (n = 9) than in survivors (n = 7), while T-lymphocyte-associated IL-2, IL-6, IL-10, and TNF-alpha and monocyte-associated IL-10 and TNF-alpha proportions decreased in the nonsurvivors.


CONCLUSIONS
These results suggest that diminished lymphocyte- and monocyte-associated proinflammatory and anti-inflammatory cytokine levels are associated with worse prognosis in patients with severe sepsis.
Cabioglu
Neslihan
N
Department of Surgery, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey.
Bilgic
Sema
S
Deniz
Gunnur
G
Aktas
Esin
E
Seyhun
Yalcýn
Y
Turna
Akif
A
Gunay
Kayhan
K
Esen
Figen
F
D018806:APACHE; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D007378:Interleukins / Q000097:blood; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D011498:Protein Precursors / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000276:immunology* / Q000401:mortality; D012772:Shock, Septic / Q000097:blood / Q000276:immunology / Q000401:mortality; D013601:T-Lymphocytes / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
C000606589:CALCA protein, human; D016207:Cytokines; D006023:Glycoproteins; D007378:Interleukins; D011498:Protein Precursors; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide