BLOOD INTERLEUKIN-10 LEVELS PARALLEL THE SEVERITY OF SEPTIC SHOCK

Purpose: The aim of this study was to investigate the relation between interleukin (IL) 10, tumor necrosis factor alpha (TNF alpha), IL-1, a nd IL-6 levels in patients with septic shock and relate these cytokine levels to the development of organ failure. Patients and Methods: In 11 patients with septic shock of recent onset, blood was sampled for d eterminations of TNF, IL-1, IL-6, and IL-10. The degree of organ failu re was scored for four organ systems (respiratory, hepatic, renal, hem atologic) in the first 48 hours of the study. Results: The APACHE II s core was 21 +/- 4. Three patients died, IL-10 levels were directly cor related with TNF levels (r = 0.73, P < .05) and IL-6 levels (r = 0.67, P < .05); and inversely correlated with total C3 (r = -0.73, P < .05) and CH50 (r = -0.68, P < .05). Both IL-10 and TNF levels were correla ted to the organ failure score (r = 0.75 and r = 0.68, both P < .01). Six patients with high IL-10 levels (> 60 pg/mL) had lower C3 (37 +/- 11 v 62 +/- 10 mg/dL) and CH50 (32 +/- 7 v 68 +/- 19%), and higher org an failure scores (5.7 +/- 0.8 v 3.8 +/- 1.3) than those with low IL-1 0 levels (all P < .05). Conclusion: Although IL-10 has an inhibitory e ffect on the production of cytokines, it is released together with TNF and IL-6 in patients with septic shock. IL-10 blood levels are direct ly related to the severity of inflammation and the development of orga n failure in septic shock. (C) 1997 by W.B. Saunders Company.