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The compensatory anti-inflammatory cytokine interleukin 10 response in pediatric sepsis-induced multiple organ

L Doughty1, J A Carcillo, S Kaplan

  • 1Department of Pediatrics, Wilford Hall Medical Center, Lackland AFB, USA.

Chest
|June 19, 1998
PubMed

Insights

In pediatric sepsis, higher levels of interleukin 10 (IL-10) correlate with multiple organ failure. Exogenous IL-10 may reduce early inflammation, but its use in later stages requires careful consideration of individual immune responses.

Area of Science:

  • Pediatric critical care medicine
  • Immunology
  • Sepsis research

Background:

  • Sepsis-induced multiple organ failure (MOF) is a critical condition in children.
  • The role of anti-inflammatory cytokines, such as interleukin 10 (IL-10), in pediatric sepsis-induced MOF is not fully understood.

Purpose of the Study:

  • To investigate the circulating IL-10 response during the development of sepsis-induced MOF in children.
  • To explore the relationship between IL-10 levels and organ failure severity, inflammatory markers, and outcomes.

Main Methods:

  • A prospective study was conducted in a university pediatric intensive care unit.
  • Plasma IL-10, IL-6, and nitrite+nitrate levels were measured in 53 children with sepsis and 15 critically ill children without sepsis.
  • Ex vivo whole blood cultures were used to assess the effect of IL-10 on IL-6 levels.

Main Results:

  • Children with three or more organ failures exhibited significantly higher plasma IL-10 levels compared to those with fewer organ failures.
  • Elevated IL-10 levels were observed in children with sequential pulmonary/hepatic/renal failure and in non-survivors on day 3.
  • IL-10 levels correlated with IL-6 and nitrite+nitrate levels, and exogenous IL-10 reduced ex vivo IL-6 production.

Conclusions:

  • A persistent compensatory anti-inflammatory cytokine response, characterized by elevated IL-10, is associated with pediatric sepsis-induced MOF.
  • Exogenous IL-10 administration may attenuate the early pro-inflammatory response in sepsis.
  • Rational use of IL-10 in later stages of pediatric sepsis necessitates understanding individual immune responsiveness and potential for persistent infection.
Abstract

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