Persistent anti-inflammatory cytokine release in septic shock

Introduction: During septic shock dysregulation of monocyte cytokine release contributes to immunosuppression. We evaluated the difference in release of the pro-inflammatory cytokine tumor necrosis factor (TNF-α) and the anti-inflammatory cytokine interleukin 10 (IL-10) from blood monocytes isolated from healthy individuals and septic shock patients. Methods: Blood mononuclear cells from healthy volunteers (n=10, Normal) and septic shock patients (n=10, SS) were isolated and cultured. Culture plate adherent monocytes were incubated with either medium (Control) or LPS (LPS) for 18 hours at 31°C. The supernatant was collected and analyzed for TNF-α and IL-10 by ELISA. Values are mean ± SEM, * p<0.05 vs. control Results TNF- α ng/ml Normal SS Control .54±.12 .82±.25 LPS 3.26±1* 1.26±.31 IL-10 pg/ml Normal SS Control 71±26 10±4 LPS 414±170* 171±91* Conclusion: Monocytes from patients with septic shock demonstrated an attenuated secretion of the pro-inflammatory cytokine TNF-α. In contrast, the secretion of the anti-inflammatory cytokine IL-10 is unchanged. The persistence of IL-10 secretion may exacerbate the immunosuppression that develops in patients with septic shock.