Early measurement of IL-10 predicts the outcomes of patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation

Abstract

Patients diagnosed with acute respiratory distress syndrome are generally severely distressed and associated with high morbidity and mortality despite aggressive treatments such as extracorporeal membrane oxygenation (ECMO) support. To identify potential biomarker of predicting value for appropriate use of this intensive care resource, plasma interleukin-10 along with relevant inflammatory cytokines and immune cell populations were examined during the early and subsequent disease courses of 51 critically ill patients who received ECMO support. High interleukin-10 levels at the time of ECMO installation and during the first 6 hours after ECMO support of these patients stand as a promising biomarker associated with grave prognosis. The initial interleukin-10 level is correlated to other conventional risk evaluation scores as a predictive factor for survival, and furthermore, elevated interleukin-10 levels are also related to a delayed recovery of certain immune cell populations such as CD14+CD16+, CD14+TLR4+ monocytes, and T regulator cells. Genetically, high interleukin-10 is associated to two polymorphic nucleotides (−592 C and −819 C) at the interleukin-10 gene promoter area. Our finding provides prognostic and mechanistic information on the outcome of severely respiratory distressed patients, and potentially paves the strategy to develop new therapeutic modality based on the principles of precision medicine.

Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury

“…We found significant increases in TNF-␣ and IL-10 after 120 min and significant increases in IL-6, -8, -12, and -1␤ after 180 min in all 7 animals who received LPS and developed ARDS, which is similar to cytokine profiles in other porcine models of ALI and ARDS (12). Importantly, the rapid and massive increases of TNF-␣, IL1-␤, IL-6, IL-8, and IL-10 that were observed in our model have been shown to be linked to mortality in ARDS patients (9). Interestingly, the PFR increased 60 -120 min before an increase in cytokines could be detected, indicating that online monitoring of particle flow may be a new, complementary approach in the clinic for early detection of ARDS.…”

Current Understanding of Leukocyte Phenotypic and Functional Modulation During Extracorporeal Membrane Oxygenation: A Narrative Review

“…During neonatal and adult ECMO, a dramatic fall of neutrophils and monocytes is consistently described. It can occur within 2 h of ECMO cannulation ( 13 , 14 , 22 ). In contrast to CPB where the number of leukocytes increased during open heart surgeries ( 40 , 43 ), leukocytopenia has long been reported in ECMO ( 16 , 25 ).…”

Extracorporeal life support and systemic inflammation

“…Greater release of IL-10 after CPB was associated with improved cardiac index and pulmonary gas exchange [85] and increased chance of survival following cardiogenic shock in adults supported with ECMO [86]. Additionally, IL-10 levels in ARDS patients correlated with severity of illness and predicted unsuccessful ECMO weaning and mortality [87].…”