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Crit Care. 2011;15(5):R224. doi: 10.1186/cc10464. Epub 2011 Sep 22.

Serial increase of IL-12 response and human leukocyte antigen-DR expression in severe sepsis survivors.

Author information

  • 1Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Mai-Chin Road, Keelung, 204, Taiwan. whanpyng@cgmh.org.tw

Abstract

INTRODUCTION:

Sepsis-induced immunosuppression may result in death. The mechanisms of immune suppression include loss of macrophage and monocyte expression of the major histocompatibility complex, increased anti-inflammatory cytokine expression and decreased expression of proinflammatory cytokines. In this study, we sought to determine the mechanisms of immune suppression in severe sepsis by repeated detection.

METHODS:

We designed this prospective observational study to measure monocyte human leukocyte antigen (HLA)-DR expression, plasma cytokine levels and cytokine responses on days 1 and 7 in stimulated peripheral blood mononuclear cells (PBMCs) of healthy controls and patients with severe sepsis.

RESULTS:

Of the 35 enrolled patients, 23 survived for 28 days and 12 died, 6 of whom died within 7 days. Plasma levels of IL-1β, IL-6, IL-10, IL-17, transforming growth factor (TGF)-β1 and TNF-α were higher, but plasma IL-12 level was lower in septic patients than those in controls. Day 1 plasma levels of IL-1β, IL-6, IL-10 and TGF-β1 in nonsurvivors were higher than those in survivors. Day 7 plasma IL-10 levels in nonsurvivors were higher than in survivors. IL-1β response was higher, but IL-12 and TNF-α responses were lower in septic patients than in controls. Day 1 IL-6 response was lower, but day 1 TGF-β1 response was higher in nonsurvivors than in survivors. Plasma IL-6 and IL-10 levels were decreased in survivors after 6 days. IL-6 response was decreased in survivors after 6 days, but IL-12 response was increased. Monocyte percentage was higher, but positive HLA-DR percentage in monocytes and mean fluorescence intensity (MFI) of HLA-DR were lower in septic patients than in controls. MFI of HLA-DR was increased in survivors after 6 days.

CONCLUSIONS:

Monocyte HLA-DR expression and IL-12 response from PBMCs are restored in patients who survive severe sepsis.

PMID:
21939530
[PubMed - indexed for MEDLINE]
PMCID:
PMC3334770
Free PMC Article
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