PMID- 16447034
OWN - NLM
STAT- MEDLINE
DCOM- 20090209
LR  - 20181113
IS  - 1432-055X (Electronic)
IS  - 0003-2417 (Linking)
VI  - 55
IP  - 5
DP  - 2006 May
TI  - [Influence of gender on stimulated cytokine response in patients with severe 
      sepsis].
PG  - 515-27
AB  - AIM: Studies suggest that female mice have lower mortality rates than males after 
      sepsis or trauma-hemorrhage. This study investigated the impact of gender and 
      disease severity on monocyte hyporesponsiveness in severe human sepsis. METHODS: 
      We prospectively investigated 49 (male n=28, female n=21) consecutive patients 
      with severe sepsis. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 
      (IL-10) were assayed by ELISA in unstimulated whole blood cultures or after 
      stimulation with lipopolysaccharide (LPS; E. coli 0111:B4) or Staph. aureus Cowan 
      strain I (SAC-I) lysate at days 1, 2, 3, 4, and 8 after enrollment. Testosterone 
      and estradiol levels were quantified by electrochemoluminescence immunoassays. 
      RESULTS: Mortality was similar for males (35.7%) and females (42.9%). While 
      disease severity was also comparable, septic patients showed a substantial 
      suppression in stimulated TNF-alpha response compared to healthy controls who 
      recovered within 8 days in surviving patients. Stimulated cytokine response 
      recovered in female non-surviving patients, while it remained suppressed in 
      non-surviving male patients and was significantly different compared to female 
      non-surviving patients. Testosterone levels were substantially suppressed in male 
      but not female septic patients compared to normal values but did not differ 
      between surviving and non-surviving patients. Estradiol levels were elevated in 
      female and male septic patients. Addition of different concentrations of 
      testosterone and estradiol to whole blood obtained from younger (<35 years old) 
      and older (>60 years old) male as well as from younger (proestrous premenopausal) 
      and older (postmenopausal) female non-septic volunteers revealed no effect on 
      LPS-stimulated TNF-alpha and IL-10 release. CONCLUSION: Severe sepsis leads to a 
      substantial suppression of stimulated cytokine response. Prolonged suppression 
      may serve as a marker of unfavourable outcome in male but not in female 
      individuals suffering from severe sepsis. Furthermore, our data suggest that 
      gender differences in cellular immunity described for young, sexually mature 
      animals obviously persist in typical postmenopausal intensive care unit patients, 
      although a direct interaction between testosterone or estradiol and 
      LPS-stimulated cytokine response could not be demonstrated.
FAU - Bauer, I
AU  - Bauer I
AD  - Klinik fur Anaesthesiologie, Intensivmedizin und Schmerztherapie, Universitat des 
      Saarlandes, Homburg, Germany. aiibau@uniklinik-saarland.de
FAU - Bauer, M
AU  - Bauer M
FAU - Raddatz, A
AU  - Raddatz A
FAU - Luedtke, C
AU  - Luedtke C
FAU - Werth, M
AU  - Werth M
FAU - Silomon, M
AU  - Silomon M
FAU - Rensing, H
AU  - Rensing H
FAU - Wilhelm, W
AU  - Wilhelm W
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Einfluss des Geschlechts auf die stimulierbare Zytokinantwort bei Patienten mit 
      schwerer Sepsis.
PL  - Germany
TA  - Anaesthesist
JT  - Der Anaesthesist
JID - 0370525
RN  - 0 (Cytokines)
RN  - 0 (Lipopolysaccharides)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 130068-27-8 (Interleukin-10)
RN  - 3XMK78S47O (Testosterone)
RN  - 4TI98Z838E (Estradiol)
SB  - IM
MH  - APACHE
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cytokines/*metabolism
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Estradiol/blood
MH  - Female
MH  - Humans
MH  - Interleukin-10/metabolism
MH  - Leukocyte Count
MH  - Lipopolysaccharides/pharmacology
MH  - Male
MH  - Middle Aged
MH  - Monocytes/metabolism
MH  - Prospective Studies
MH  - Sepsis/*metabolism/mortality
MH  - Sex Characteristics
MH  - Stimulation, Chemical
MH  - Survival Analysis
MH  - Testosterone/blood
MH  - Tumor Necrosis Factor-alpha/metabolism
EDAT- 2006/02/01 09:00
MHDA- 2009/02/10 09:00
CRDT- 2006/02/01 09:00
PHST- 2006/02/01 09:00 [pubmed]
PHST- 2009/02/10 09:00 [medline]
PHST- 2006/02/01 09:00 [entrez]
AID - 10.1007/s00101-006-0983-x [doi]
PST - ppublish
SO  - Anaesthesist. 2006 May;55(5):515-27. doi: 10.1007/s00101-006-0983-x.