The -1082 interleukin-10 polymorphism is associated with acute respiratory failure after major trauma: a prospective cohort study.
BACKGROUND
Acute respiratory failure is a common, life-threatening complication after severe trauma. Polymorphisms in cytokine genes, linked to cytokine inducibility, may influence the susceptibility to acute respiratory failure and serve as risk predictors.


METHODS
This PROSPECTIVE cohort study (n = 100) included Caucasian multiple trauma (Injury Severity Score [ISS] >15) patients at a level 1 trauma center in Berlin, Germany. Primary outcome measure acute respiratory failure was defined as a Pao(2)/fraction of inspired oxygen (Fio(2)) ratio of <200 and the need for mechanical respiratory support. We investigated the association of polymorphisms of the interleukin (IL)-1beta, IL-6, and IL-10 genes with acute respiratory failure.


RESULTS
Of 100 patients with severe mechanic injury (median ISS 34, interquartile range 19-45), 49 developed acute respiratory failure. Acute respiratory failure frequency differed significantly with the IL-10 -1082 genotype (P = .007; P corrected, .03), whereas there was no significant relation to any other cytokine genotype after Bonferroni correction for multiple testing. The -1082 GG genotype was a marker of decreased risk to develop acute respiratory failure in univariate (odds ratio [OR], 0.2; 95% confidence interval [CI], 0.1-0.6; P = .004) and multivariate (OR, 0.2; 95% CI, 0.1-0.9; P = .03) logistic regression analysis, with male gender, severe abdominal injury, and an APACHE II score >19 being significant risk factors.


CONCLUSIONS
We conclude that the IL-10 -1082 genotype may be a risk marker for development of acute respiratory failure after trauma.
Schroeder
Ove
O
Department of Orthopedic and Trauma Surgery, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany.
Schulte
Klaus-Martin
KM
Schroeder
Julia
J
Ekkernkamp
Axel
A
Laun
Reinhold Alexander
RA
D000328:Adult; D015331:Cohort Studies; D016207:Cytokines / Q000235:genetics; D005260:Female; D005786:Gene Expression Regulation / Q000276:immunology; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D016753:Interleukin-10 / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000000981:diagnostic imaging / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging / Q000235:genetics*; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000150:complications
D016207:Cytokines; D016753:Interleukin-10