ABSTRACT
This study is an observational case control study that was planned to evaluate the circulating levels of interferon gamma [IFNy], a T helper-1 cytokine, and interlukin-10 [IL-10], which is derived mainly from T helper 2 cells, in septic children to highlight their role in sepsis and relation to outcome and to test the state of Th1/Th2 cytokine balance in these patients. The study was carried out in Mansoura University Children's Hospital in the period from March to November, 2002 and included 48 children with sepsis that were consecutively admitted to Our hospital in addition to 12 healthy children with matched age and sex as control. Patients were classified into 4 groups [each including 12 patients]; sepsis, sepsis syndrome, septic shock and multiple organ dysfunction syndrome, after fulfillment of the inclusion criteria of each definition. IFN[gamma] and IL-10 were measured in serum samples, taken from all subjects on admission, by enzyme immunoassay [Titrezyme perspective Biosystems and Immunotec]. Results revealed significantly higher serum IFN and IL-10 levels in all patient groups than control [p<0.001] and both cytokines were higher in severe forms of sepsis. Non survivors had significantly lower blood pressure [p=0.01] while total leukocytic count, granulocytic count, IFN[gamma] and IL-10 were significantly higher in these patients [p=0.02, <0.001, 0.002, <0.001 respectively]. Multiple stepwise regression analysis showed that TLC, IFN[gamma] and IL-10 were the most important predictors of poor outcome with a regression coefficient of 89.6%
Conclusion: both IFN[gamma] and IL-10 are increased in septic children especially in severe forms correlating with outcome that suggests a role in disease pathogenesis. Both Th1 and Th2 cells are operating at least for some time during the Course of sepsis