title: Immune cytokine response in combat casualties: blast or explosive trauma with or without secondary sepsis.
abstract: The aim of this study was to assess the prognostic value of tumor necrosis factor (TNF) alpha, interleukin (IL)-8, IL-4, and IL-10 in combat casualties. Fifty-six casualties with severe trauma (blast and explosive) who developed sepsis and 20 casualties with the same severity of trauma without sepsis were enrolled in this study. Fifty-five casualties developed multiple organ dysfunction syndrome; 36 died. Blood was drawn on the first day of trauma. Concentrations of IL-8, TNF-alpha, IL-4, and IL-10 were determined in plasma using enzyme-linked immunosorbent assays. Mean values of IL-8 were 230-fold, IL-10 were 42-fold, and TNF-alpha were 17-fold higher in trauma and sepsis group (p < 0.01). Mean values of IL-8 were 60-fold, TNF-alpha were 43.5-fold, and IL-10 were 70-fold higher in the multiple organ dysfunction syndrome group (p < 0.01). Mean values of IL-8 were 2.3-fold and IL-10 were 1.4-fold higher in nonsurvivors and TNF-alpha were 2.2-fold higher in survivors (p < 0.01). IL-4 had no significance as a predictor of severity and outcome.
authors.affiliation: Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Cmotravska 17, 11000 Belgrade, Serbia.
authors.forename: Maja
authors.initials: M
authors.lastname: Surbatovic
authors.forename: Nikola
authors.initials: N
authors.lastname: Filipovic
authors.forename: Sonja
authors.initials: S
authors.lastname: Radakovic
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Stankovic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Slavkovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001753:Blast Injuries / Q000097:blood / Q000150:complications / Q000276:immunology*; D002648:Child; D016207:Cytokines / Q000097:blood* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006801:Humans; D016753:Interleukin-10 / Q000097:blood* / Q000276:immunology; D016209:Interleukin-8 / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000209:etiology / Q000276:immunology*; D015599:Trauma Severity Indices; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000276:immunology; D014857:Warfare
chemical_list: D015415:Biomarkers; D016207:Cytokines; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10