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High interleukin 12 and low interleukin 10 production after in vitro stimulation detected in sepsis survivors.

Stanilova SA, Karakolev ZT, Dimov GS, Dobreva ZG, Miteva LD, Slavov ES, Stefanov CS, Stanilov NS

Department of Molecular Biology, Immunology, and Genetics, Faculty of Medicine, Thrakia University, Stara Zagora, Bulgaria. stanilova@mf.uni-sz.bg

OBJECTIVE: To evaluate viability of isolated peripheral blood mononuclear cells (PBMC) and production of cytokines in vitro after stimulation as prognostic factors for survival in sepsis patients. DESIGN: Prospective study of the biological response of PBMC in the onset of severe sepsis. SETTING: Research laboratory of molecular biology and immunology and university hospital ICU, Faculty of Medicine, Trakia University. PATIENTS: Twenty-three patients meeting the criteria for severe sepsis, and 14 control subjects. INTERVENTIONS: Isolated PBMC were stimulated in vitro with: C3-binding glycoprotein (C3bgp; 30 microg), lipopolysaccharide (30 microg), phytohemagglutinin (20 microg), pokeweed mitogen (30 microg), and dexamethasone (500 microg). MEASUREMENTS AND RESULTS: We measured the levels of interleukins (IL) 6, 10, and 12 in culture supernatants. Stimulation with C3bgp and phytohemagglutinin led to significantly lower PBMC secretion of IL-6 in nonsurvivors than in survivors and healthy donors. Stimulation with C3bgp, lipopolysaccharide, and pokeweed mitogen considerably reduced IL-12 production in nonsurvivors. Stimulation with lipopolysaccharide and pokeweed mitogen caused immune cells in nonsurvivors to produce higher levels of IL-10 than in survivors. Survival of PBMC reduced viability for nonsurvivors' PBMC, both spontaneously and as induced by lipopolysaccharide or pokeweed mitogen. CONCLUSIONS: The viability of PBMC at the onset of sepsis and enhanced production of IL-12 and diminished production of IL-10 after stimulation with all stimuli used may be a favorable prognostic factor in sepsis.

Published 7 March 2005 in Intensive Care Med, 31(3): 401-7.
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