IFNγ/IL10 ratio stratifies corticosteroids therapy for septic shock
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ABSTRACT: To stratify hydrocortisone application in septic shock, we investigated an immune sub-study of the CORTICUS trial (Sprung et.al 2008, NEJM) employing machine learning to a panel of 120 parameters of 84 patients (n=24 non-survived, n=60 survived, 28 days) with special emphasis on potentially disadvantageous corticosteroids effects in the context of sepsis including clinical parameters, organ failure scores, lymphocyte counts and plasma protein concentrations of cytokines. We identified the ratio of IFNγ/IL10 in serum before randomization to serve as a valid biomarker for treatment stratification. This was validated with cytokine serum levels of patients (n=49) from the SISPCT study (Bloos et.al 2016, JAMA) and the early arm (n=20) of a hydrocortisone cross-over study (Keh et.al. 2003, Am J Respir Crit Care Med). Integrating these three studies, we yielded an odds ratio of 2.1 and a 95% confidence interval of 0.99-4.52 (P=0.03).In vitro assays revealed IFNγ/Il10 to reflect the burden or severity of systemic infection. Severity was evidencedbyserum levels of these cy-tokines in the patients with septic shock we observed, and also in patients with less severe sepsis. Elucidating the molecular regulation of leukocytes during treatment and placebo by a transcriptomics analysis pointed to induced recovery of immune cell function due to hydro-cortisone treatment, particularly in the predicted hydrocortisone responders. IFNγ/IL10 is a molecular marker with high potential for support of hydrocortisone therapy decision. IFNγ/IL10 is reasonable for this as it reflects the burden and recovery of the immune system which seems to be indicative for corticosteroids treatment of septic shock.
ORGANISM(S): Homo sapiens
PROVIDER: GSE106878 | GEO | 2019/10/01
REPOSITORIES: GEO
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