Release of proinflammatory cytokines by mitogen-stimulated peripheral blood mononuclear cells from critically ill multiple-trauma victims

This study investigated the alterations in circulating proinflammatory cyto kines and cytokine production by peripheral blood mononuclear cells (PBMCs) in response to lipopolysaccharide (LPS) or phytohemagglutinin (PHA) after severe trauma, Plasma and PBMCs were collected from 17 severely injured tra uma patients and 10 healthy subjects. Plasma was stored at -80 degrees C an d analyzed for cytokines. Isolated PBMCs from each subject were stimulated with LPS or PHA and incubated at 5% CO2 for 24 hours. Supernatants were col lected and analyzed for cytokines. There was no significant change in the p lasma concentration of free TNF-alpha and IL-1 beta between healthy subject s and trauma patients. Plasma IL-6, total TNF-alpha, and total IL-1 beta we re significantly increased in severely traumatized patients compared with h ealthy control subjects. PBMCs from trauma patients produced higher levels of TNF-alpha in response to LPS but it showed no significant change in IL-1 beta and IL-6 production in response to PHA or LPS in comparison to PBMCs from control subjects. We conclude that severe trauma results in a signific ant increase in plasma proinflammatory cytokine IL-6. Free TNF-alpha and IL -1 beta in plasma remain at levels comparable to those in uninjured control s, while plasma free IL-6 levels in trauma patients remain high. Serious in jury is associated with an enhanced production of TNF-alpha by PBMCs stimul ated with LPS. Copyright (C) 1999 by W.B. Saunders Company.