HUMAN PERIPHERAL MONONUCLEAR-CELLS DO NOT SHOW PROINFLAMMATORY PATTERNS OF CYTOKINE TRANSCRIPTION IN EARLY TRAUMA - A PRELIMINARY-REPORT

Injury has been hypothesized to cause inflammation through systemic re lease of lipopolysaccharide and pro-inflammatory cytokines, but this h as proved difficult to demonstrate in humans. We looked for evidence o f an inflammatory pattern of cytokine gene expression by peripheral bl ood mononuclear cells (PBM) in six polytraumatized patients (ISS = 25 +/- 8) upon ER admission, and in six matched healthy controls. PBM tum or necrosis factor (TNF)-alpha, interleukin (Il)-1 beta, IL-4, IL-6, I L-10, and interferon (IFN)-gamma message was assessed by semi-quantita tive reverse-transcription polymerase chain reaction. No increase in e xpression of any of the pro-inflammatory cytokines (tumor necrosis fac tor-alpha, IL-1 beta, or IL-6) was found after trauma, and IFN-gamma t ended to decrease. Of the immunosuppressive cytokines, IL-10 expressio n increased 5-fold (p<.05) but no change in IL-4 was discerned. This p attern is fundamentally different from the cytokine expression pattern s expected with sepsis or exposure to lipopolysaccharide. These findin gs are inconsistent with the occurrence of systemic endotoxemia and su bsequent global immunocyte activation early after trauma.