Open Access

ARTICLE

Pro- and anti-inflammatory responses are regulated simultaneously from the first moments of septic shock

Eduardo Tamayo^1,2,*, Ana Fernández^1,2,*, Raquel Almansa^2,3,*, Elena Carrasco^1,2, María Heredia^1,2, Carmen Lajo^1,2, Lisbeth Goncalves^2,3, Jose I. Gómez-Herreras^1,2, Raúl Ortiz de Lejarazu², Jesus F. Bermejo-Martin^2,3,4

1 Anesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid
2 Investigación Médica en Infección e Inmunidad (IMI). Hospital Clínico Universitario de Valladolid-IECSCYL, Valladolid
3 Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid
4 Grupo Cooperativo de Investigación Biomédica en Inmunología (CIBI), Madrid, Spain

* Corresponding Author: J.F. Bermejo-Martin,

European Cytokine Network 2011, 22(2), 82-87. https://doi.org/10.1684/ecn.2011.0281

Accepted 02 May 2011;

Abstract

The relationships between cytokine responses in septic shock are currently poorly understood. Some studies have pointed to a biphasic model, with an initial proinflammatory phase, followed by a reactive, antiinflammatory response to explain the pathogenesis of the most severe form of sepsis. However, evidence for the coexistence of both responses has been found. In this study, the plasma levels of 17 cytokines and chemokines, in 20 patients with septic shock, 11 patients with systemic inflammatory response syndrome (SIRS), during the first 24 hours following diagnosis, and 10 healthy controls, were analyzed and compared. Patients with septic shock showed increased levels of IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and IL-10 compared to healthy controls. Patients with SIRS showed higher levels of IL-6, IL-8, MCP-1, MIP-1β, G-CSF and IL-10 than controls. Patients with septic shock showed higher levels of IL-8, GM-CSF, MIP-1β than those with SIRS. The Spearman test demonstrated a positive association between the pro-inflammatory mediators IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and the immunomodulatory cytokine IL-10 in septic shock. Consequently, correlation studies supported the notion that secretion of pro- and anti-inflammatory mediators in septic shock occurs as a simultaneous immune response program initiated early in the course of the disease, revealing that both types of cytokine play a role from the very beginning of this life-threatening condition.

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