ABSTRACT
Objective To detect the changes of interleukin-18 (IL-18) in plasma of trauma patients and evaluate their value in early warning of organ dysfunction. Methods A prospective study was carried out in 54 trauma patients admitted in from March 2001 to September 2002, which were divided into low injury severity score(ISS) group (Group L-ISS) and high ISS group (Group H-ISS). ELISA was applied to measure the level of IL-18 of blood samples that were collected on arrival, at days 4, 7 and 14 following admission. In the meantime, IL-18 level of plasma samples from patients with systemic inflammatory response syndrome (SIRS), sepsis and multiorgan dysfunction syndrome (MODS) was retrospectively analyzed so as to calculate the critical value of IL-18 in predicting organ dysfunction. Results After trauma, IL-18 concentration of plasma reached peak at days 4 and 7, and decreased gradually at day 14, which was significantly related to SIRS, sepsis and MODS, respectively. The IL-18 level was high relatively in plasma from patients with organ dysfunction. The higher IL-18 level in plasma within seven days after trauma indicated the severer organ dysfunction. Conclusion IL-18 is sensitive in early warning of organ dysfunction after trauma.
ABSTRACT
To investigate the dynamic changes in ICE mRNA expression and its relationship with IL 18 and IFN ? mRNA expression in thermal injured rats.The animals were subjected to a 30% total body surface area full thickness thermal injury,and fluid resuscitation was performed at 6 hours post burn. 54 male Wistar rats were randomly divided into three groups: normal controls,30% Ⅲ degree burn group,and selective decontamination of the digestive tract (SDD) treatment group. P1asma endotoxin was measured by limulus amebocyte lysate test,and tissue ICE,IL 18 and IFN ? mRNA expression was determined by reverse transcription po1ymerase chain reaction (RT PCR).The results showed that ICE, IL 18, and IFN ? mRNA expression significantly increased in the intestine,1ung,liver,and kidney at 2 hours,peaking at 8 hours,and a high level was maintained till 24 hours. However, treatment with SDD could lower plasma endotoxin levels,and markedly inhibit ICE, IL 18, and IFN ? mRNA expression in various organs.This study suggests that major burns can lead to a marked elevation of tissue ICE mRNA expression in vital organs,which might be associated with IL 18 and IFN ?mRNA expression induced by gut derived endotoxemia.