• Huang-Pin Wu, Chia-Ling Wu, Chian-Kuang Chen, Kong Chung, Jo-Chi Tseng, Yu-Chih Liu, and Duen-Yau Chuang.
• Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan, ROC.
• J Crit Care. 2008 Dec 1;23(4):519-24.

PurposeSepsis is a complicated syndrome in which proinflammatory and anti-inflammatory cytokines are expressed simultaneously. However, it remains unclear for the expression of interleukin (IL)-4 and IL-4delta2 in patients with severe sepsis.Materials And MethodsBy nested reverse transcriptase-polymerase chain reaction and the expression of glyceraldehydes-3-phosphate dehydrogenase as the internal reference, the expression levels of IL-4 and IL-4delta2 were determined in peripheral blood mononuclear cells (PBMCs) of 76 patients with severe sepsis and were immediately admitted to an intensive care unit. Plasma IL-4 level was measured by enzyme-linked immunosorbent assay. Clinical characteristics were monitored and recorded prospectively.ResultsThe IL-4 messenger RNA (mRNA) expression in PBMCs of patients who had survived was significantly higher than that of those who had died. The IL-4delta2/IL-4 ratio in PBMCs of patients who had survived was significantly lower than that of those who had died. The IL-4delta2 expression did not differ between survivors and nonsurvivors. After regression analysis, the IL-4delta2/IL-4 ratio still was an independent factor for death in patients with severe sepsis. The expression of IL-4delta2 mRNA was positively correlated with that of IL-4 mRNA in patients with severe sepsis. The plasma IL-4 levels in septic patients on admission day did not differ between survivors and nonsurvivors.ConclusionsThe IL-4 mRNA expression might be associated with survival in patients with severe sepsis. The IL-4delta2/IL-4 ratio might be served as the net immunity of IL-4 activity.

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