The -1082 interleukin-10 polymorphism is associated with acute respiratory failure after major trauma: A prospective cohort study.

Background: Acute respiratory failure is a common, life-threatening complication after severe trauma. Polymorphisms in cytokine genes, linked to cytokine inducibility, may influence the susceptibility to acute respiratory failure and serve as risk predictors. Methods: This PROSPECTIVE cohort study (n = 100) included Caucasian multiple trauma (Injury Severity Score [ISS] >15) patients at a level 1 trauma center in Berlin, Germany. Primary outcome measure acute respiratory failure was defined as a Pao ₂/fraction of inspired oxygen (Fio ₂) ratio of <200 and the need for mechanical respiratory support. We investigated the association of polymorphisms of the interleukin (IL)-1β, IL-6, and IL-10 genes with acute respiratory failure. Results: Of 100 patients with severe mechanic injury (median ISS 34, interquartile range 19-45), 49 developed acute respiratory failure. Acute respiratory failure frequency differed significantly with the IL-10 -1082 genotype (P = .007; P corrected, .03), whereas there was no significant relation to any other cytokine genotype after Bonferroni correction for multiple testing. The -1082 GG genotype was a marker of decreased risk to develop acute respiratory failure in univariate (odds ratio [OR], 0.2; 95% confidence interval [CI], 0.1–0.6; P = .004) and multivariate (OR, 0.2; 95% CI, 0.1–0.9; P = .03) logistic regression analysis, with male gender, severe abdominal injury, and an APACHE II score >19 being significant risk factors. Conclusion: We conclude that the IL-10 -1082 genotype may be a risk marker for development of acute respiratory failure after trauma. [Copyright &y& Elsevier]