Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis

Introduction. Severe sepsis in humans may be related to an underlying profound immune suppressive state. We investigated the link between gene expression of immune regulatory cytokines and the range of illness severity in patients with infection and severe sepsis. Methods. A prospective observation...

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Main Authors: Robert Grealy, Mary White, Patrick Stordeur, Dermot Kelleher, Derek G. Doherty, Ross McManus, Thomas Ryan
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Mediators of Inflammation
Online Access:http://dx.doi.org/10.1155/2013/164246
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author Robert Grealy
Mary White
Patrick Stordeur
Dermot Kelleher
Derek G. Doherty
Ross McManus
Thomas Ryan
author_facet Robert Grealy
Mary White
Patrick Stordeur
Dermot Kelleher
Derek G. Doherty
Ross McManus
Thomas Ryan
author_sort Robert Grealy
collection DOAJ
description Introduction. Severe sepsis in humans may be related to an underlying profound immune suppressive state. We investigated the link between gene expression of immune regulatory cytokines and the range of illness severity in patients with infection and severe sepsis. Methods. A prospective observational study included 54 ICU patients with severe sepsis, 53 patients with infection without organ failure, and 20 healthy controls. Gene expression in peripheral blood mononuclear cells (PBMC) was measured using real-time polymerase chain reaction. Results. Infection differed from health by decreased expression of the IL2, and IL23 and greater expression of IL10 and IL27. Severe sepsis differed from infection by having decreased IL7, IL23, IFNγ, and TNFα gene expression. An algorithm utilising mRNA copy number for TNFα, IFNγ, IL7, IL10, and IL23 accurately distinguished sepsis from severe sepsis with a receiver operator characteristic value of 0.88. Gene expression was similar with gram-positive and gram-negative infection and was similar following medical and surgical severe sepsis. Severity of organ failure was associated with serum IL6 protein levels but not with any index of cytokine gene expression in PBMCs. Conclusions. Immune regulatory cytokine gene expression in PBMC provides a robust method of modelling patients’ response to infection.
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series Mediators of Inflammation
spelling doaj-art-78a16d18691d4cbbbe5d5840cd78dd3a2025-08-20T02:07:31ZengWileyMediators of Inflammation0962-93511466-18612013-01-01201310.1155/2013/164246164246Characterising Cytokine Gene Expression Signatures in Patients with Severe SepsisRobert Grealy0Mary White1Patrick Stordeur2Dermot Kelleher3Derek G. Doherty4Ross McManus5Thomas Ryan6Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, St James’s Hospital, Dublin 8, IrelandDepartment of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, St James’s Hospital, Dublin 8, IrelandService d’Immunologie, Hôpital Erasme, Brussels, BelgiumDepartment of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, St James’s Hospital, Dublin 8, IrelandDepartment of Clinical Immunology, Institute of Molecular Medicine, Trinity College Dublin, St James’s Hospital, Dublin 8, IrelandDepartment of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, St James’s Hospital, Dublin 8, IrelandDepartment of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, St James’s Hospital, Dublin 8, IrelandIntroduction. Severe sepsis in humans may be related to an underlying profound immune suppressive state. We investigated the link between gene expression of immune regulatory cytokines and the range of illness severity in patients with infection and severe sepsis. Methods. A prospective observational study included 54 ICU patients with severe sepsis, 53 patients with infection without organ failure, and 20 healthy controls. Gene expression in peripheral blood mononuclear cells (PBMC) was measured using real-time polymerase chain reaction. Results. Infection differed from health by decreased expression of the IL2, and IL23 and greater expression of IL10 and IL27. Severe sepsis differed from infection by having decreased IL7, IL23, IFNγ, and TNFα gene expression. An algorithm utilising mRNA copy number for TNFα, IFNγ, IL7, IL10, and IL23 accurately distinguished sepsis from severe sepsis with a receiver operator characteristic value of 0.88. Gene expression was similar with gram-positive and gram-negative infection and was similar following medical and surgical severe sepsis. Severity of organ failure was associated with serum IL6 protein levels but not with any index of cytokine gene expression in PBMCs. Conclusions. Immune regulatory cytokine gene expression in PBMC provides a robust method of modelling patients’ response to infection.http://dx.doi.org/10.1155/2013/164246
spellingShingle Robert Grealy
Mary White
Patrick Stordeur
Dermot Kelleher
Derek G. Doherty
Ross McManus
Thomas Ryan
Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis
Mediators of Inflammation
title Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis
title_full Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis
title_fullStr Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis
title_full_unstemmed Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis
title_short Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis
title_sort characterising cytokine gene expression signatures in patients with severe sepsis
url http://dx.doi.org/10.1155/2013/164246
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