title: The interleukin-4 expression in patients with severe sepsis.
abstract: OBJECTIVE
  Sepsis is a complicated syndrome in which proinflammatory and anti-inflammatory cytokines are expressed simultaneously. However, it remains unclear for the expression of interleukin (IL)-4 and IL-4delta2 in patients with severe sepsis.
  
  
  METHODS
  By nested reverse transcriptase-polymerase chain reaction and the expression of glyceraldehydes-3-phosphate dehydrogenase as the internal reference, the expression levels of IL-4 and IL-4delta2 were determined in peripheral blood mononuclear cells (PBMCs) of 76 patients with severe sepsis and were immediately admitted to an intensive care unit. Plasma IL-4 level was measured by enzyme-linked immunosorbent assay. Clinical characteristics were monitored and recorded prospectively.
  
  
  RESULTS
  The IL-4 messenger RNA (mRNA) expression in PBMCs of patients who had survived was significantly higher than that of those who had died. The IL-4delta2/IL-4 ratio in PBMCs of patients who had survived was significantly lower than that of those who had died. The IL-4delta2 expression did not differ between survivors and nonsurvivors. After regression analysis, the IL-4delta2/IL-4 ratio still was an independent factor for death in patients with severe sepsis. The expression of IL-4delta2 mRNA was positively correlated with that of IL-4 mRNA in patients with severe sepsis. The plasma IL-4 levels in septic patients on admission day did not differ between survivors and nonsurvivors.
  
  
  CONCLUSIONS
  The IL-4 mRNA expression might be associated with survival in patients with severe sepsis. The IL-4delta2/IL-4 ratio might be served as the net immunity of IL-4 activity.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan, ROC.
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Wu
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Wu
authors.forename: Chian-Kuang
authors.initials: CK
authors.lastname: Chen
authors.forename: Kong
authors.initials: K
authors.lastname: Chung
authors.forename: Jo-Chi
authors.initials: JC
authors.lastname: Tseng
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Liu
authors.forename: Duen-Yau
authors.initials: DY
authors.lastname: Chuang
mesh_terms: D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases / Q000097:blood; D006801:Humans; D015847:Interleukin-4 / Q000096:biosynthesis*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D011446:Prospective Studies; D012333:RNA, Messenger / Q000096:biosynthesis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018805:Sepsis / Q000097:blood*
chemical_list: D012333:RNA, Messenger; D015847:Interleukin-4; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases