Investigation of the changes of cytokines in infants with immunological activated or immunosuppressed status of sepsis

Abstract

Objective To investigate the changes of cytokines in infants with immunological activated or immunosuppressed status of sepsis.Methods Thirty-six infants with sepsis and 16 age-matched healthy infants were enrolled from May to November in 2007.Thirty-six infants were divided into two groups according to the levels of HLA-DR expression:DR-H group(HLA-DR expression ＞ 30%)and DR-L group (HLA-DR expression ＜30%).CD14 + monocyte HLA-DR expression was analyzed by flow cytometry.Cytokine(IL-1β、IL-6、TNF-α、IL-10)were measured by enzyme-linked immunosorbent assay.Real-time PCR were used to evaluate the mRNA levels of IL-6 and IL-10 in CD4+ T cells.Results(1)Pediatric critical illness score in DR-H group was higher than that in DR-L group(P ＜ 0.05).(2)Serum concentrations of pro-inflammatory cytokine(IL-1β,IL-6)elevated significantly in DR-H group and DR-L group(P ＜ 0.05).Serum concentrations of TNF-α elevated significantly in DR-H group.There was no significant difference of IL-1β and IL-6 between DR-H and DR-L group,while protein level of TNF-α in DR-H group was higher than that in DR-L group(P ＜0.05).Transcription level of IL-6 mRAN was significantly up-regulated in DRH group and DR-L group(P ＜0.05),especially in DR-L group in which IL-6 level was higher than that in DR-H group.The protein level of ant-inflammatory cytokine(IL-10)increased significantly in DR-H group and DR-L group(P ＜ 0.05),the mRNA level of ILl0 raised significantly in DR-L group(P ＜ 0.05),while mRNA and protein levels of IL-10 in DR-L group were higher than those in DR-H group(P ＜ 0.05).Conclusion HLA-DR expression of monocytes cells could be a valuable index to judge the critical level of pediatric illness and serve as an index to predict outcome of infant with sepsis.Over-expression of pro-inflammatory cytokine was found along with all the phage of sepsis.High expression of IL-10 may be contributed to immune suppression in infant with sepsis. Key words: Sepsis; HLA-DR; Cytokine; Infant