4th Department of Internal Medicine, University of Athens, Medical School, Greece.
Cytokine. 2010 Jan;49(1):89-94. doi: 10.1016/j.cyto.2009.08.016. Epub 2009 Sep 23.
Controversial findings of former clinical trials on the effect of low dose hydrocortisone in patients with septic shock led to investigate the effect of corticosteroids on the production of cytokines from endotoxin (LPS)-stimulated whole blood.
Whole blood from 33 septic patients was sampled within 24h alter diagnosis. Hydrocortisone was not administered during follow-up. Whole blood was stimulated with 30 ng/ml of LPS in the presence of 0.01, 0.1, 1 and 10 microM of dexamethasone. Concentrations of cytokines and of sTREM-1 were estimated in supernatants after six hours of incubation.
Dexamethasone inhibited LPS-stimulated release of TauNuFalpha, of IL-6, of IL-8 and of IL-10 in dose-dependent manner. A dual effect on the kinetics of release of IL-1beta and of sTREM-1 was shown. Release of IL-1beta was either decreased, what was connected with unfavorable outcome, or it was unaffected what was connected with a favorable outcome. Release of sTREM-1 was either increased, what was connected with unfavorable outcome, or it was decreased what was connected with a favorable outcome.
Part of the beneficiary effect of corticosteroids in sepsis may be due to an effect on the release of IL-1beta and of sTREM-1. This effect does not seem to be homogeneous for all septic patients.
先前关于低剂量氢化可的松对脓毒性休克患者疗效的临床试验结果存在争议，这促使我们研究皮质类固醇对脂多糖（LPS）刺激的全血中细胞因子产生的影响。
在诊断后 24 小时内采集 33 例脓毒症患者的全血。在随访期间未给予氢化可的松。全血用 30ng/ml 的 LPS 刺激，同时存在 0.01、0.1、1 和 10μM 的地塞米松。孵育 6 小时后，估计上清液中细胞因子和 sTREM-1 的浓度。
地塞米松以剂量依赖的方式抑制 LPS 刺激的 TauNuFalpha、IL-6、IL-8 和 IL-10 的释放。还显示了对 IL-1beta 和 sTREM-1 释放动力学的双重影响。IL-1beta 的释放要么减少，与不良结局相关，要么不受影响，与良好结局相关。sTREM-1 的释放要么增加，与不良结局相关，要么减少，与良好结局相关。
皮质类固醇在脓毒症中的部分有益作用可能归因于对 IL-1beta 和 sTREM-1 释放的影响。这种作用似乎对所有脓毒症患者并不均匀。
