Significance of the determination of proinflammatory cytokines in the serum of polytraumatized patients with sepsis

Abstract

Severe sepsis and trauma complicated with multiple organ dysfunction syndrome (MODS) are among the leading causes of death in intensive therapy units with mortality rate exceeding 50%. The outcome is not determined only by infection or trauma, but also by the intensity of immuno-inflammatory response, which is essential for host defence, but if uncontrolled leads to MODS. Pro-inflammatory cytokines (tumor necrosis factor-a -TNF-a, IL-1 IL-8, IL-12, IFN-g, etc) represent a part of this immuno-inflammatory response to an insult. The results of the clinical investigation of correlation between pro-inflammatory cytokines (IL-8, IL-12, TNF-a, IFN-g) the outcome (survivors, non-survivors), and the severity (systemic inflammatory response syndrome - SIRS - less severe, and MODS - more severe) in polytraumatised patients with sepsis are presented in this paper. Mean values of IL-8 were 1.3-fold higher in non-survivors (p<0.05), and 60-fold higher in MODS group (p<0.01). Mean values of IL-12 were 1.6-fold higher in survivors (p<0.01), while the values between SIRS and MODS group did not differ significantly; mean values of TNF-a were 3-fold higher in survivors (p<0.05), and 46-fold higher in MODS group (p<0.01). Mean values of IFN-g did not differ significantly between the two groups regarding the outcome and severity. The obtained results indicated that IL-8 was a reliable predictor of lethal outcome and MODS (p<0.01), IL-12 a reliable predictor of survival (p<0.05), and TNF-a a reliable predictor of survival (p<0.05) and MODS (p<0.01).

Keywords

• multiple trauma
• sepsis
• cytokines
• multiple organ failure
• interleukin-8
• interleukin-12
• tumor necrosis factor
• interferon type II
• survival
• treatment outcome