T-helper-17, Regulatory T-helper Cells Related Serum Markers and IL-13 in the Outcome of Polytraumatic Patients with Bacteremia.

ABSTRACT

BACKGROUND: Bacteremia and sepsis are associated with high mortality, increased hospital stays, and associated costs, especially in trauma patients. Sepsis is a fatal immunological disorder and its pathophysiology is still poorly understood. OBJECTIVE: To ascertain the role of T-helper lymphocyte-related inflammatory serum cytokines in trauma patients with blood culture positive with Gram-negative bacteria. METHODS: Peripheral blood samples (5 ml) were collected from 40 trauma patients on the day of obtaining positive blood culture (i.e., day 0), followed by an appropriate antimicrobial treatment and sample acquisition on day 4 and only once from 40 age-matched healthy controls. Bead-based cytometric analysis was used to quantify extracellular levels of 16 serum cytokines. The cytokine profiles were compared with those in healthy controls and then correlated to clinical outcomes. RESULTS: A total of 40 patients were enrolled during the study period. Of these, 24 patients (60%) were discharged while 16 (40%) had a fatal outcome. Statistically significant elevated levels of serum IL-6, IFN-γ, TNF-α, IL-17A, IL-17F, and IL-4 were observed in septic patients, while lowered IL-13 levels correlated significantly with a favorable outcome. CONCLUSION: Sepsis following trauma elicits a heightened immune response in the body and provokes the production of a diverse array of cytokines that is both pro-inflammatory and anti-inflammatory. However, the unique cytokine profile of septic trauma patients is still not well understood.