Detection of the circulating proinflammatory and anti-inflammatory cytokines in patients with SARS and the evaluation of their clinical significance
Objective To detect the concentrations of the proinflammatory(IL-12P70, IL-1β, TNF-α, IL-6, IL-8) and the anti-inflammatory cytokines (IL-10)in plasma of patients with severe acute respiratory syndrome(SARS). To evaluate the potent role of these cytokines in the process of SARS. Methods Six circulating proinflammatory and anti-inflammatory cytokines levels were measured in 48 patients with SARS, who were subdivided into a group of the recovered ( n =27) and a group of the dead ( n =20) in a variety of ages and a healthy control group ( n =10) by means of BD cytometric bead array(BD CBA). Kruskal-Wallis test, χ 2 test and Mann-Whitney U test were made for data analysis by SPSS10.0 for windows. Results The concentrations of all 6 cytokines (IL-12P70, IL-1β, TNF-α, IL-6, IL-8 and IL-10) in plasma of patients with SARS increased significantly in both survivor and dead groups compared with control group ( P 0.05). The concentrations of all 6 cytokines in the dead group were significantly higher than those in the survivor group ( P 0.05). The concentration of IL-6 reached to the peak at day 2-12(median 7) after the onset of the symptoms ( P 0.05)and then fell significantly( P 0.05), and so was the ratio of IL-6/IL-10( P 0.05). The highest concentration of IL-8 was at day 8-19(median 13) after the onset of the symptoms while compared with the other two time points( P 0.05). Conclusion The significant differentiation of the concentrations of these 6 cytokines among the 3 groups suggests that SARS patients experience severe inflammatory and anti-inflammatory reaction. IL-6 seems to be the major proinflammatory cytokine at the early stage of the illness, and may be of prognostic importance.