Toliver-Kinsky Tracy E, Varma Tushar K, Lin Cheng Y, Herndon David N, Sherwood Edward R
Department of Anesthesiology, The University of Texas Medical Branch, Galveston 77555-0591, USA.
Shock. 2002 Oct;18(4):322-30. doi: 10.1097/00024382-200210000-00006.
Thermal injury to 40% or more of the total body surface area poses a significant risk for the development of opportunistic infections that increase complications and mortality. Altered cytokine induction profiles, including suppression of the Th1 cytokines IFN-gamma and IL-12 and elevations in the anti-inflammatory cytokine IL-10, are believed to contribute to burn-associated immunosuppression and the development of sepsis. The specific changes that lead to altered cytokine production following major burns are not known. We examined the effects of burn injuries to 40% of the mouse body surface on IFN-gamma induction in the major IFN-gamma-producing cell types of the spleen. Additionally, effects on key IFN-gamma-regulatory cytokines were examined after bacterial challenge. We report that in vivo induction of IFN-gamma in natural killer lymphocytes is suppressed in burned mice. Splenic IFN-gamma was suppressed at both the mRNA and protein levels. Early suppression was associated with impairments in both the macrophage/dendritic cell and lymphocyte populations, whereas persistent suppression was associated with impaired lymphocyte function and decreased responsiveness to IFN-gamma-inducing factors. IFN-gamma production could be restored by neutralization of the upregulated cytokine IL-10. Induction of the IFN-gamma-inducers IL-15, IL-12, and IL-2 was also impaired after burn injury, whereas IL-18 levels remained unaffected. Exogenous application of these suppressed cytokines to isolated splenocytes did not restore IFN-gamma to sham levels, indicating a loss of responsiveness to these factors. Expression of the IL-2, IL-12, and IL-15 receptors was suppressed after thermal injury. We conclude that burn-associated suppression of IFN-gamma is due to deficient production of inducing factors and their receptors, leading to severe impairments in cellular IFN-gamma induction pathways.
全身表面积40%或更多的热损伤会带来发生机会性感染的重大风险,这种感染会增加并发症和死亡率。细胞因子诱导谱的改变,包括Th1细胞因子IFN-γ和IL-12的抑制以及抗炎细胞因子IL-10的升高,被认为与烧伤相关的免疫抑制和脓毒症的发生有关。导致严重烧伤后细胞因子产生改变的具体变化尚不清楚。我们研究了小鼠体表40%烧伤对脾脏主要产生IFN-γ的细胞类型中IFN-γ诱导的影响。此外,在细菌攻击后检测了对关键IFN-γ调节细胞因子的影响。我们报告称,烧伤小鼠体内自然杀伤淋巴细胞中IFN-γ的诱导受到抑制。脾脏IFN-γ在mRNA和蛋白质水平均受到抑制。早期抑制与巨噬细胞/树突状细胞和淋巴细胞群体的损伤有关,而持续抑制与淋巴细胞功能受损和对IFN-γ诱导因子的反应性降低有关。通过中和上调的细胞因子IL-10可恢复IFN-γ的产生。烧伤后IFN-γ诱导剂IL-15、IL-12和IL-2的诱导也受损,而IL-18水平未受影响。将这些受抑制的细胞因子外源性应用于分离的脾细胞并不能将IFN-γ恢复到假手术水平,表明对这些因子的反应性丧失。热损伤后IL-2、IL-12和IL-15受体的表达受到抑制。我们得出结论,烧伤相关的IFN-γ抑制是由于诱导因子及其受体的产生不足,导致细胞IFN-γ诱导途径严重受损。