Shinichiro Suzaki

Change in the ratio of interleukin-6 to interleukin-10 predicts a poor outcome in patients with systemic inflammatory response syndrome.

OBJECTIVE To examine whether changes in interleukin (IL)-6 and IL-10 concentrations in patients with systemic inflammatory response syndrome (SIRS) can predict a poor outcome. DESIGN Prospective study. SETTING Emergency and intensive care unit of a medical school hospital. PATIENTS Twenty-five patients who fulfilled the criteria for SIRS. INTERVENTIONS Blood samples were collected for cytokine determinations. MEASUREMENTS AND MAIN RESULTS IL-6 and IL-10 concentrations were measured by enzyme-linked immunosorbent assay in plasma samples. Blood samples were obtained at 0, 1, 2, and 4 days from patients who fulfilled the criteria for SIRS. Of 25 patients, 19 survived and the other six patients died of multiple organ failure. Although IL-6 and IL-10 concentrations in survivors decreased gradually from 186.1 +/- 34.4 to 93.6 +/- 18.9 (SEM) pg/mL (p < .05) and from 77.4 +/- 21.2 to 32.0 +/- 11.8 pg/mL (p < .05), IL-6 concentrations in nonsurvivors did not. Although the ratio of IL-6 to IL-10 in survivors was almost stable, the ratio in nonsurvivors increased from 5.5 +/- 3.1 to 18.7 +/- 2.8 (p < .05). Multivariate analysis showed that when heart rate, mean arterial pressure, IL-6, IL-10, and the ratio of IL-6 to IL-10 were taken into account, there only remained a relationship between the ratio of IL-6 to IL-10 and outcome. CONCLUSIONS In nonsurvivors, IL-6 concentrations did not decrease, IL-10 concentration decreased, and the ratio of IL-6 to IL-10 increased. An increase in the ratio of IL-6 to IL-10 indicated a correlation with a poor outcome.

The ratio of interleukin-6 to interleukin-10 correlates with severity in patients with chest and abdominal trauma

To evaluate the relation between proinflammatory cytokines and antiinflammatory cytokines after major trauma, we measured pro-inflammatory cytokine (interleukin [IL]-6) and antiinflammatory cytokine (IL-10) concentrations after trauma, and evaluated the relationship between the ratio of IL-6 to IL-10 and injury severity. In 20 patients who sustained chest and abdominal trauma, IL-10, IL-6, and lactate concentrations were measured at 0, 1, 2, and 4 days. The Injury Severity Score (ISS), Acute Physiology and Chronic Health Evaluation (APACHE) II score, and the ratio of IL-6 to IL-10 were calculated. IL-6, IL-10, and lactate concentrations were 197.2+/-28.4 (mean +/- SEM), 71.1+/-10.1 pg/mL, and 46.7+/-9.4 mg/dL at entry. These concentrations were significantly decreased at day 4. The ratio of IL-6 to IL-10 was 3.11+/-0.47 at entry and was significantly correlated with ISS (r=.872, P<.01), APACHE II score (r=.887, P<.01). The IL-10, IL-6, and lactate concentrations were elevated immediately after major trauma, and the ratio of IL-6 to IL-10 was correlated with injury severity. This suggests that the ratio of IL-6 to IL-10 may be used to predict the injury severity after trauma.

A New Drug Screening System “MULTI-HPLC” by High Performance Liquid Chromatography Using Multiwavelength UV Detector and Its Clinical Application

We have developed a new drug screening system, MULTI-HPLC, a high performance liquid chromatography (HPLC) system that uses a simultaneous multiwavelength ultraviolet (UV) detector. In this system, HPLC coupled with a 32-channel photodiode-array UV detector can provide multidimensional chromatographic information about compounds and yield identification and quantification of unknown intoxicating agents rapidly and nearly automatically by computer assistance. This detector can provide spectral data. Special attention is given to spectral interpretation techniques (spectrum search function, peak deconvolution, retention prediction program). Possible applications of this system were demonstrated in clinical cases and were found useful and practical, especially in multidrug poisoning. The comprehensive drug screening and quantification within a short turnaround time allow the toxicology laboratory to assume a much more important role in the diagnosis and management of acute poisoning patients.