ABSTRACT
<p><b>PURPOSE</b>Host response to polytrauma occasionally has unpredictable outcomes. Immune response is a major factor influencing patient's outcome. This study evaluated the interaction of two main cytokines in immune response after major trauma, specifically interleukin-6 (IL-6) and interleukin-10 (IL-10). Plasma level of these cytokines is determined by mRNA expression of these cytokines genes which may decide the outcome of polytrauma patients.</p><p><b>METHODS</b>This prospective multicenter trial held at four trauma centers enrolled 54 polytrauma patients [Injury Severity Score (ISS) ≥ 16]. Plasma levels and mRNA expression of IL-6 and IL-10 were measured for 5 days after trauma. Clinical evaluation was conducted to observe whether patients endured multiple organ dysfunction syndrome (MODS) and death. MODS evaluation was performed using sequential organ failure assessment (SOFA). Trauma load which in this study is represented with ISS, plasma level, expression of cytokine genes and patient's outcome were examined with correlation test and statistical analysis.</p><p><b>RESULTS</b>The elevated IL-6/IL-10 ratio indicated increased activity of systemic inflammation response, especially pro-inflammation response which bears higher probability of progressing to MODS and death. The decline of IL-6/IL-10 ratio with heavy trauma load (ISS > 30) showed that compensatory anti-inflammation response syndrome (CARS) state was more dominant than systemic inflammatory response syndrome (SIRS), indicating that malfunction and failure of immune system eventually lead to MODS and deaths. The statistical significance in plasma level of cytokines was found in the outcome group which was defined as bearing a low trauma load but mortality.</p><p><b>CONCLUSION</b>The pattern of cytokine levels in inflammation response has great impact on the outcome of polytrauma patients. Further study at the genetic level is needed to investigate inflammation process which may influence patient's outcome.</p>
ABSTRACT
Objective To evaluate the clinical efficacy of Yangyin Yiqi mixture and western medicine in the treatment of oral lichen planus(OLP)and its effect on the levels of interferon -γ(IFN -γ)and interleukine -10 (IL -10)in serum and saliva.Methods Sixty patients with OLP were randomly divided into control group(n =30) and treatment group(n =30).The control group was treated with triamcinolone acetonide and lidocaine,local injec-tion.The treatment group was treated with Yangyin Yiqi mixture on the basis of the control group.The treatment lasted two months.After treatment,the clinical efficacy,objective indicators score,levels of IFN -γand IL -10 in serum and saliva,adverse reactions were compared between the two groups.Results The overall response rate of the treatment group (86.67%)was significantly higher than that of the control group (63.33%)(χ2 =11.64,P <0.01).After treatment,the two groups'objective index score significantly reduced(t =8.52,12.51,all P <0.01),and the treat-ment group's objective indicators rating was significantly lower than the control group (t =4.38,P <0.05).After treatment,the levels of IFN -γin serum and saliva were (25.39 ±1.29)pg/mL and (12.76 ±1.28)pg/mL,which were significantly increased in the treatment group (t =10.35,8.15,all P <0.01),so did the control group (P <0.05).And the levels of IL -10 in serum and saliva were (27.54 ±1.82)pg/mL and (9.92 ±0.86)pg/mL,and the levels were significantly decreased in the two groups after treatment (t =8.76,9.39,all P <0.01,t =4.65,4.94,all P <0.05).And levels of IFN -γin serum and saliva of the treatment group were significantly higher than those of the control group (t =4.68,4.32,all P <0.05),and levels of IL -10 in serum and saliva of the treatment group were significantly lower than those of the control group (t =5.41,5.25,all P <0.05).During treatment,there were no sig-nificant adverse reactions.Conclusion Yangyin Yiqi mixture combined with western medicine has definitive clinical efficacy in the treatment of OLP.It can significantly increase the level of IFN -γand reduce the level of IL -10 in serum and saliva in patients,so provide theory value for treatment of OLP.
ABSTRACT
PURPOSE: Polymorphonuclear leukocytes (PMNs) are the first line of cellular response for host defense during acute inflammation. The ability of PMNs to produce and release numerous pro-inflammatory cytokines is now estabilished and plays an important role in triggering and maintaining the inflammatory response. We studied the autocrine downregulation of this process by invesgating the potential production by human PMNs of the major anti-inflammatory cytokine, interleukine 10 (IL-10). METHODS: Human PMNs were isolated from the peripheral blood of health volunteers by using the modified boyum method. Human PMNs were incubated at 37 degrees Cwith and without formyl Met-Leu-Phe (fMLP) for 30 minute, 2 hours, 4 hours, and 20 hours. The level of IL-10 was determined in each of the cell-free supernatants by using the enzyme linked immunosorbent assay (ELISA) method. RESULTS: Non-stimulated PMNs generated 1.40 +/- 1.791pg/mL to 3.46 +/- 1.607 pg/mL of IL-10 over the time course. Stimulation with fMLP resulted in an increase in the constitutive PMN-derived IL-10 by 2.74 +/- 0.762 pg/mL, 1.27 +/- 0.262 pg/mL, 1.19 +/- 0.364 pg/mL, and 2.44 +/- 1.317 pg/mL at 30 min, 2 hr, 4 hr, and 20 hr after stimulation, respectively, but these increases were not statiscally significant. CONCLUSION: Human PMNs seem unable to induce release of the most potent anti-inflammatory cytokine, IL-10, and down-regulate inflammatory response due to the autocrine mechanism. This could partly account for the persistence of local inflammation, when PMNs are the main infiltrating cells.