LYMPH OF PATIENTS WITH A SYSTEMIC INFLAMMATORY RESPONSE SYNDROME INHIBITS LIPOPOLYSACCHARIDE-INDUCED CYTOKINE PRODUCTION

In patients with systemic inflammatory response syndrome (SIRS), toler ance of peripheral blood mononuclear cells to a second challenge with lipopolysaccharide (LPS) has been described. Thoracic duct lymph trans ports LPS and represents the extravascular, interstitial fluid compart ment of the body. The aim of this study was to determine the capacity of lymph to influence LPS-induced cytokine production in vitro. Thorac ic duct lymph was obtained from patients with SIRS and without SIRS (c ontrols). The effect of lymph and simultaneously collected plasma on L PS-induced cytokine production by normal peripheral blood mononuclear cells was assessed. Both lymph and plasma of patients with SIRS reduce d LPS-induced tumor necrosis factor-alpha and interleukin-ti productio n (P <.01); lymph of controls also inhibited cytokine production (P <. 01), although to a lesser extent. This study suggests that LPS toleran ce may occur both in the intra- and extravascular compartments.