The interleukin-4 expression in patients with severe sepsis

• Published in: Journal of critical care Vol. 23; no. 4; pp. 519 - 524
• Main Authors: Wu, Huang-Pin, Wu, Chia-Ling, Chen, Chian-Kuang, Chung, Kong, Tseng, Jo-Chi, Liu, Yu-Chih, Chuang, Duen-Yau
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2008; Elsevier Limited
• Subjects: Aged; Annealing; Critical Care; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Glyceraldehyde-3-Phosphate Dehydrogenases - blood; Hospitals; Human; Humans; Intensive care; Interleukin-4; Interleukin-4 - biosynthesis; Interleukin-4 δ2; Leukocytes, Mononuclear - metabolism; Lymphocytes; Male; Personal relationships; Plasma; Polymerase chain reaction; Prospective Studies; Proteins; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger - biosynthesis; Sepsis; Sepsis - blood; Tuberculosis; Human; Interleukin-4; Sepsis; Interleukin-4 δ2; Cytokines
• DOI: 10.1016/j.jcrc.2007.11.008
• ISSN: 0883-9441; 1557-8615

Sepsis is a complicated syndrome in which proinflammatory and anti-inflammatory cytokines are expressed simultaneously. However, it remains unclear for the expression of interleukin (IL)–4 and IL-4 δ2 in patients with severe sepsis. By nested reverse transcriptase–polymerase chain reaction and the expression of glyceraldehydes-3-phosphate dehydrogenase as the internal reference, the expression levels of IL-4 and IL-4 δ2 were determined in peripheral blood mononuclear cells (PBMCs) of 76 patients with severe sepsis and were immediately admitted to an intensive care unit. Plasma IL-4 level was measured by enzyme-linked immunosorbent assay. Clinical characteristics were monitored and recorded prospectively. The IL-4 messenger RNA (mRNA) expression in PBMCs of patients who had survived was significantly higher than that of those who had died. The IL-4 δ2/IL-4 ratio in PBMCs of patients who had survived was significantly lower than that of those who had died. The IL-4 δ2 expression did not differ between survivors and nonsurvivors. After regression analysis, the IL-4 δ2/IL-4 ratio still was an independent factor for death in patients with severe sepsis. The expression of IL-4 δ2 mRNA was positively correlated with that of IL-4 mRNA in patients with severe sepsis. The plasma IL-4 levels in septic patients on admission day did not differ between survivors and nonsurvivors. The IL-4 mRNA expression might be associated with survival in patients with severe sepsis. The IL-4 δ2/IL-4 ratio might be served as the net immunity of IL-4 activity.