Abstract
Background: Interleukin-10 (IL-10) is an important anti-inflammatory cytokine that play a key role in sepsis. It is a potent endogenous anti-inflammatory cytokine that decrease lung inflammation. Our aim was to identify clinical risk factors and IL-10 (592/1082) polymorphism in children with septic shock.
Methods: This is a prospective study. Children with severe sepsis and septic shock admitted to our PICU and healthy individuals were recruited into the study. The genotypes of polymorphisms-1082, -592 were determined by PCR restriction fragment length polymorphism. Clinical factors and PRISM III score were also recorded.
Results: In the period of our study, we enrolled 36 children with 8.3% (n=3) of severe sepsis and 91.7% (n=33) of septic shock. The mean age was 65.5±15.5 month. Their mortality was 19.4%, which significantly reduced from the past few years (40%, p=0.02). The mortality was significantly associated with high PRISM III score (16.7±5.7, 10.5±6.3, p=0.02) and delay resuscitation. The A allele of the SNP IL-10-592 polymorphism was more common in septic shock group compared to normal control (66.7% vs 56%, OR=1.94 [0.57-6.76], p=0.2) and A/A allele was also more common in septic shock group (44.4, 29.2 OR=1.94, 95% CI 0.57-6.76, p=0.2). The A/A allele of SNP IL-10-1082 polymorphism was more prevalent in sepsis but not significantly different between sepsis and control (32 [88.9%], 20 [83.3%] OR=1.1, 95% CI 0.21-5.92, p=0.9). In addition, there was a trend of A/A SNP-1082 genotype in the mortality group (100% vs 86.2%, p=0.1).
Conclusions: Our sepsis mortality was significantly associated with high PRISM III score and the delay in resuscitation. The AA allele of SNP IL-10-592/-1082 polymorphism had a trend to increase severity and susceptibility in children with sepsis.
Rujipat Samransamruajkit, Krittiya Nakornchai, Khemmachart Pongsanon, Jitladda Deerojanawong, Suchada Sritippayawan, Nuanchan Prapphal
