PubMed · 5629265
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Briquemont, Brouwez, Schonne. 1967-04-30. [Mesenteric infarctus].. https://pubmed.ncbi.nlm.nih.gov/5629265/
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Early release of macrophage-derived proinflammatory cytokines, such as tumor necrosis factor (TNF), interleukin (IL)-1, and IL-6, are important in the pathogenesis of septic shock and multisystem organ failure in various models of sepsis. IL-10 is a mediator that inhibits cytokine release from activated macrophages. The aim of this study was to determine if IL-10 would decrease serum cytokine elevation in a murine model of cecal ligation and puncture (CLP). CLP in animals is a model that closely mimics the physiologic changes seen in human sepsis. Four groups of 14 female Swiss-Webster mice were used. Group 1 underwent laparotomy alone, groups 2, 3, and 4 underwent laparotomy and CLP. Groups 1 and 2 received intraperitoneal (IP) saline injections to serve as control vehicle. Group 3 (prophylactic) received 10,000 U IP IL-10 1 hr prior to CLP and every 3 hr thereafter. Group 4 (therapeutic) received 10,000 U IP IL-10 1 hr following CLP and every 3 hr thereafter. Animals were sacrificed at 3 and 9 hr following CLP. Serum TNF-alpha, IL-1 beta, and IL-6 were determined by enzyme-linked immunosorbent assay (ELISA), CLP produced a significant rise in serum TNF,IL-6, and IL-1 in untreated controls. Prophylactic or therapeutic administration of IL-10 significantly attenuated this early rise in serum cytokines. These results support the hypothesis that (1) CLP produces an early systemic rise in macrophage-derived cytokines and (2) IL-10 given either before or after the onset of CLP-induced intraabdominal infection and sepsis is able to inhibit this early release of macrophage-derived systemic mediators. IL-10 has potential clinical benefits in the therapeutic management of intraabdominal infection and sepsis.
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An increased plasma lactate concentration (PLC) is a recognized danger signal often found in cases of shock, septicaemia, hepatic and renal failure, and diabetic ketoacidosis. In 120 patients with abdominal complaints, we found the PLC to be above normal limits in 96 per cent (24/25) of the mesenteric ischaemia subgroup, in all 20 of the general bacterial peritonitis subgroup, in 30 per cent (6/20) of the acute pancreatitis subgroup, and in about half of the 25 cases of intestinal obstruction. In all other abdominal conditions represented (n = 30), comprising various inflammatory or infectious abdominal diseases, the PLC was within the normal range. In patients with abdominal complaints, an increased PLC usually indicates the needs of emergency surgery. In the present series, the PLC manifested a sensitivity of 96 per cent and a specificity of 38 per cent as a marker of mesenteric ischaemia, and was also found to be a useful aid in the diagnosis of bowel obstruction and general bacterial peritonitis.