PRODUCTION OF PRO- AND ANTIINFLAMATORY CYTOKINES, APOPTOSIS AND OXIDATIVE STRESS ARE ESSENTIAL FOR THE OUTCOME IN SEVERE SEPSIS

To investigate in vitro secretion of cytokines from stimulated peripheral blood mononuclear cells (PBMC) in the early phase of severe sepsis (septic phase) and one month later in postseptic phase, when the patient is stabilized (healthy stage). The quantity determinations of TNF-, IL-6, IL-12 and IL-10 were performed in culture supernatant by ELISA. The level of apoptosis of cultured cells was determined as well. The plasma level of lipid peroxidation products (MDA) as a marker of oxidative stress and the activity of the erythrocyte antioxidant enzyme catalase (CAT) in the patient during the septic stage were also explored. We observed no significant difference in the secreted quantity of TNF and IL-6 upon LPS, C3bgp, PHA and PWM stimulation alone by the PBMC of the patient. The IL-12 production depended on the individual stimuli applied. Further, the patients’ PBMC in post septic stage exhibited a suppressed IL-12 production. A well expressed hyporeactivity of PBMC isolated from septic stage towards the production of IL-10 upon stimulation, was also observed while the production of IL-10 in post-septic stage in different quantities depended on the stimuli used. At the same time the rate of apoptosis has clear prevalence in septic stage and is greatly influenced by different stimuli.