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The interleukin-4 expression in patients with severe sepsis
Huang-Pin Wu1, Chia-Ling Wu, Chian-Kuang Chen
1Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan, ROC.
Journal of Critical Care
|December 6, 2008
Summary
Interleukin-4 (IL-4) mRNA expression in severe sepsis patients is linked to survival. The IL-4delta2/IL-4 ratio may indicate net IL-4 immune activity and predict mortality risk.
Area of Science:
- Immunology
- Critical Care Medicine
- Molecular Biology
Background:
- Sepsis involves complex immune responses with simultaneous pro- and anti-inflammatory cytokine expression.
- The roles of specific cytokines like interleukin-4 (IL-4) and its variant IL-4delta2 in severe sepsis are not fully understood.
Purpose of the Study:
- To investigate the expression levels of IL-4 and IL-4delta2 in patients with severe sepsis.
- To determine the association of IL-4 and IL-4delta2 expression with patient survival and mortality.
Main Methods:
- Nested reverse transcriptase-polymerase chain reaction (RT-PCR) was used to measure IL-4 and IL-4delta2 mRNA in peripheral blood mononuclear cells (PBMCs).
- Glyceraldehyde-3-phosphate dehydrogenase served as the internal reference for mRNA expression.
- Plasma IL-4 levels were quantified using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Higher IL-4 mRNA expression in PBMCs was observed in survivors compared to non-survivors.
- A lower IL-4delta2/IL-4 ratio in PBMCs was associated with survival.
- IL-4delta2 expression alone did not differ between survivors and non-survivors, but the ratio remained an independent predictor of death.
- IL-4delta2 mRNA expression positively correlated with IL-4 mRNA expression.
Conclusions:
- IL-4 mRNA expression appears to be associated with survival outcomes in severe sepsis.
- The IL-4delta2/IL-4 ratio may represent the net immune activity of IL-4 and serve as a potential biomarker for predicting mortality in severe sepsis.
