Low-Dose Steroid Therapy Is Associated with Decreased IL-12 Production in PBMCs of Severe Septic Patients.

Huang-Pin Wu,Chi-Chung Shih,Tien-Hsing Chen,Duen-Yau Chuang

doi:10.1155/2016/1796094

Abstract

Background. Sepsis-induced immunosuppression may result in higher mortality rates in patients. Methods. We examined the relationship of cytokine responses from stimulated peripheral blood mononuclear cells (PBMCs) and monocyte human leukocyte antigen-DR (HLA-DR) expression (days 1 and 7) with low-dose steroid therapy in 29 septic patients. Patients were treated according to the guidelines. Thirty healthy controls were enrolled for validation. Results. Eighteen patients were prescribed low-dose steroids and 11 were not. Interleukin- (IL-) 12 responses in patients without low-dose steroid therapy on days 1 and 7 were higher than those with low-dose steroid therapy. Compared to day 1, IL-12 responses significantly increased on day 7 in patients without low-dose steroid therapy. After regression analysis, the change in the IL-12 response from day 7 to day 1 was found to be independently associated with the low-dose steroid therapy. There was no difference in monocyte HLA-DR expression between patients treated with and without low-dose steroid on day 1 or 7. No change in monocyte HLA-DR expression from day 7 to day 1 was observed in patients with or without low-dose steroid therapy. Conclusion. Decreased IL-12 response was associated with the low-dose steroid therapy in PBMCs of septic patients.

Highlights

Severe sepsis is characterized by acute release of systemic inflammatory and anti-inflammatory mediators caused by infection [1, 2]
There were no significant differences in age, gender, histories, infection sources, and initial appropriateness of antibiotics between groups with and without lowdose steroid therapy
IL-12 response observed in peripheral blood mononuclear cells (PBMCs) increased from day 7 to day 1 in severe septic patients

Summary

Introduction

Severe sepsis is characterized by acute release of systemic inflammatory (systemic inflammatory response syndrome [SIRS]) and anti-inflammatory mediators (compensatory anti-inflammatory response syndrome [CARS]) caused by infection [1, 2]. The cytokines associated with CARS include IL-4, IL-10, and transforming growth factor- (TGF-) β1 This immune imbalance results in multiorgan dysfunctions and eventually death in patients with severe sepsis [3]. We examined the relationship of cytokine responses from stimulated peripheral blood mononuclear cells (PBMCs) and monocyte human leukocyte antigen-DR (HLA-DR) expression (days 1 and 7) with low-dose steroid therapy in 29 septic patients. There was no difference in monocyte HLA-DR expression between patients treated with and without low-dose steroid on day 1 or 7. No change in monocyte HLA-DR expression from day 7 to day 1 was observed in patients with or without low-dose steroid therapy. Decreased IL-12 response was associated with the low-dose steroid therapy in PBMCs of septic patients

Results

Discussion

Conclusion