Estimating the Capacity of Nucleated Cells to Produce Cytokines using APACHE II Score for Septic Patients in a Clinical Setting

Although immune function is a factor in cases of sepsis with high mortality, it cannot be measured at the bedside. We investigated blood cytokines and the capacity of nucleated blood cells (NBCs) to produce cytokines (IL-6, 8, 10) using clinical data from septic patients, and considered how this was related to the patient outcome. This study targeted thirty patients suffering from severe sepsis or septic shock. Peripheral whole blood was collected prior to treatment for sepsis, 6 hours after such treatment, and again at 24 hours post-initiation. Residual peripheral blood was placed into laboratory dishes and exogenous lipopolysaccharide (LPS) was added (10 ng/mL). The capacity of NBCs to produce cytokines was calculated using the ratio of each cytokine before (nonLPS) and after (s-LPS) in vitro LPS stimulation (s-LPS/non-LPS). The ratio of these cytokines exhibited significant negative correlations with a higher APACHE II scores. The APACHE II score was significantly associated with a poor outcome, but there was no correlation with outcome for any other clinical data. A higher APACHE II score could be used to indirectly estimate immunoparalysis in the clinical setting.