Abstract
Background: Sepsis represents the main cause of mortality at intensive care units, with mortality rates from 30–50%. Elderly, pediatric, and immune-compromised patients show atypical clinical manifestations of bacterial infection. Several studies showed that Cytokines are involved in the pathogenesis of sepsis. We conducted this study to investigate the association of IL6-174 G/C gene polymorphism with sepsis outcome in critically ill children admitted to pediatric intensive care units. Patients and methods: Sixty children were included, thirty cases with sepsis and septic shock admitted to pediatric ICU in children’s hospital Cairo University. Their ages ranged from 2 months to 24 months (2 years), with 18 (60%) males and 12 (40%) females in comparison to 30 healthy controls. Blood samples (5 ml) were collected (2 ml. on EDTA for DNA extraction and RFLP of IL-6 gene at locus 174. The rest was used for separation of serum for determination of IL-6 protein by ELISA technique. Results: IL6 serum levels were significantly elevated in those children with septicemia and septic shock (114 pg/ml) compared to healthy matched controls (2.60 pg/ml), p <0.001. Regarding the IL6-174 genotype; G/C, G/G and CC represents 53.3%, 36.7% and 10%, respectively. Comparing the genotypes with mortality rates for those children with sepsis and septic shock, IL6-174, GC, GG and CC were 46.7%, 66.3%, and 100% respectively. Conclusion: IL6 serum levels are elevated in patients with sepsis, supporting its role in the pathogenesis of sepsis. IL6-174 G/C gene polymorphism may contribute to the prognosis and outcome of sepsis. Recommendation: Further large-scale studies are needed to clarify the role of IL6-174 genotypes in association with critical illnesses in children. Using IL-6 polymorphisms as a routine test in patients admitted to PICU may help us predict the prognosis of critically ill children, and allow for better treatment options for those who are at risk.
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