HIGH-LEVELS OF INTERLEUKIN-10 IN SERUM ARE ASSOCIATED WITH FATALITY IN MENINGOCOCCAL DISEASE

Interleukin 10 (IL-10) suppresses the production of proinflammatory cy tokines in vitro and in murine models of endotoxemia and has been sugg ested as a candidate for treatment of bacterial septicemia. To investi gate the role of IL-10 in meningococcal disease, a sandwich IL-10 enzy me-amplified sensitivity immunoassay was used to quantitate IL-10 in s erum and cerebrospinal fluid samples from 41 patients with meningococc al bacteremia or meningitis with or without septic shock. High levels of IL-10 were demonstrated in sera from patients with meningococcal se ptic shock (mean, 21,221 pg/ml; range, 25 to 64,500 pg/ml). All cases involving fatalities had IL-10 levels in serum of greater than or equa l to 1,000 pg/ml (mean, 23,058 pg/ml; range, 1,000 to 64,500 pg/ml). P atients with meningococcal meningitis without septic shock had compara bly low concentrations of IL-10 in serum (mean, 119 pg/ml; range, 0 to 1,050 pg/ml) but exhibited compartmentalized release of IL-10 in cere brospinal fluid. Concentrations of IL-10 in serum were positively corr elated with the previously reported concentrations of tumor necrosis f actor alpha, IL-6, and IL-8 in serum in the same patients. We conclude that IL-10 is extensively activated along with the proinflammatory cy tokines during the initial phase of meningococcal septic shock and tha t IL-10 is associated with fatality in meningococcal disease.