Interleukin-6 and interleukin-10 plasma levels and mRNA expression in polytrauma patients

Abstract

PurposeHost response to polytrauma occasionally has unpredictable outcomes. Immune response is a major factor influencing patient's outcome. This study evaluated the interaction of two main cytokines in immune response after major trauma, specifically interleukin-6 (IL-6) and interleukin-10 (IL-10). Plasma level of these cytokines is determined by mRNA expression of these cytokines genes which may decide the outcome of polytrauma patients.MethodsThis prospective multicenter trial held at four trauma centers enrolled 54 polytrauma patients [Injury Severity Score (ISS) ≥ 16]. Plasma levels and mRNA expression of IL-6 and IL-10 were measured for 5 days after trauma. Clinical evaluation was conducted to observe whether patients endured multiple organ dysfunction syndrome (MODS) and death. MODS evaluation was performed using sequential organ failure assessment (SOFA). Trauma load which in this study is represented with ISS, plasma level, expression of cytokine genes and patient's outcome were examined with correlation test and statistical analysis.ResultsThe elevated IL-6/IL-10 ratio indicated increased activity of systemic inflammation response, especially pro-inflammation response which bears higher probability of progressing to MODS and death. The decline of IL-6/IL-10 ratio with heavy trauma load (ISS > 30) showed that compensatory anti-inflammation response syndrome (CARS) state was more dominant than systemic inflammatory response syndrome (SIRS), indicating that malfunction and failure of immune system eventually lead to MODS and deaths. The statistical significance in plasma level of cytokines was found in the outcome group which was defined as bearing a low trauma load but mortality.ConclusionThe pattern of cytokine levels in inflammation response has great impact on the outcome of polytrauma patients. Further study at the genetic level is needed to investigate inflammation process which may influence patient's outcome.

Inflammatory response of mesenchymal stromal cells after in vivo exposure with selected trauma-related factors and polytrauma serum

“…Meduri and colleagues showed that high levels of IL1B and IL6 in plasma from ARDS patients predict a poor outcome in ARDS patients [20]. The role of inflammatory mediators in course of PT is described in many publications [4,8,20,21,34,35]. The intravenous administration of MSC may ameliorate the dysregulation of the immune system, reduce apoptosis, improve regenerative processes and prevent complications after PT.…”

“…PT patients revealed increased serum level of IL6, IL10, CXCL1 and CCL2 at the admission to hospital (0 h). The study of Sapan and colleagues included 54 PT patients and investigated the dysregulation of the immune system of PT patients by determining the ratio IL6/IL10 in plasma by ELISA and messenger RNA expression [35]. Disproportional amounts of IL6 and IL10 are a predictor for the development of multiple organ dysfunction syndrome and death [35].…”

Transient Expression of Interleukin-21 in the Second Hit of Acute Pancreatitis May Potentiate Immune Paresis in Severe Acute Pancreatitis

“…3 Furthermore, In trauma patients, a strong correlation between the mRNA and plasma levels of other inflammatory cytokines such as interleukin IL-6 and IL-10 has been shown. 45 The mRNA and protein plasma concentrations of IL-21 in SAP are elevated compared to those in MAP patients (Figure 1 and 3). Although the mRNA and protein plasma levels showed increased IL-21 in SAP compared to MAP, these were however not significant except in on day 9 (mRNA).…”

Severe Traumatic Brain Injury (TBI) Modulates the Kinetic Profile of the Inflammatory Response of Markers for Neuronal Damage

“…IL-10 is an anti-inflammatory cytokine that regulates and limits acute inflammation in response to trauma to prevent tissue damage, such as secondary brain damage after TBI [ 21 , 45 ]. IL-10 plays a crucial role in inflammatory and autoimmune diseases of the intestine, chronic infections, tumor development, neuroinflammation, -degeneration as well as multiple organ dysfunction syndrome (MODS) and MOF after polytrauma, where IL-10 levels from 21.0 to 340.7 pg/mL were shown [ 42 , 46 ]. In this study, the highest IL-10 levels were measured on admission and a continuous decrease until day 5 was shown.…”