title: Pro- and anti-inflammatory responses are regulated simultaneously from the first moments of septic shock.
abstract: The relationships between cytokine responses in septic shock are currently poorly understood. Some studies have pointed to a biphasic model, with an initial proinflammatory phase, followed by a reactive, anti-inflammatory response to explain the pathogenesis of the most severe form of sepsis. However, evidence for the coexistence of both responses has been found. In this study, the plasma levels of 17 cytokines and chemokines, in 20 patients with septic shock, 11 patients with systemic inflammatory response syndrome (SIRS), during the first 24 hours following diagnosis, and 10 healthy controls, were analyzed and compared. Patients with septic shock showed increased levels of IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and IL-10 compared to healthy controls. Patients with SIRS showed higher levels of IL-6, IL-8, MCP-1, MIP-1β, G-CSF and IL-10 than controls. Patients with septic shock showed higher levels of IL-8, GM-CSF, MIP-1β than those with SIRS. The Spearman test demonstrated a positive association between the pro-inflammatory mediators IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and the immunomodulatory cytokine IL-10 in septic shock. Consequently, correlation studies supported the notion that secretion of pro- and anti-inflammatory mediators in septic shock occurs as a simultaneous immune response program initiated early in the course of the disease, revealing that both types of cytokine play a role from the very beginning of this life-threatening condition.
authors.affiliation: Anesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tamayo
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández
authors.forename: Raquel
authors.initials: R
authors.lastname: Almansa
authors.forename: Elena
authors.initials: E
authors.lastname: Carrasco
authors.forename: María
authors.initials: M
authors.lastname: Heredia
authors.forename: Carmen
authors.initials: C
authors.lastname: Lajo
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Goncalves
authors.forename: Jose I
authors.initials: JI
authors.lastname: Gómez-Herreras
authors.forename: Raúl Ortiz
authors.initials: RO
authors.lastname: de Lejarazu
authors.forename: Jesus F
authors.initials: JF
authors.lastname: Bermejo-Martin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012772:Shock, Septic / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma