Proinflammatory cytokine surge after injury stimulates an airway immunoglobulin a increase
- PMID: 20173656
- PMCID: PMC2953611
- DOI: 10.1097/TA.0b013e3181c45284
Proinflammatory cytokine surge after injury stimulates an airway immunoglobulin a increase
Abstract
Background: : Injury stimulates an innate airway IgA response in severely injured patients, which also occurs in mice. Tumor necrosis factor (TNF)-α and interleukin (IL)-1β stimulate the production of polymeric immunoglobulin receptor, the protein required to transport immunoglobulin A (IgA) to mucosal surfaces. Blockade of TNF-α and IL-1β eliminates the airway IgA response to injury. IL-6 stimulates differentiation of B cells into IgA-secreting plasma cells at mucosal sites. We investigated the local and systemic kinetics of TNF-α, IL-1β, and IL-6 after injury in mice. We also hypothesized that injection of exogenous TNF-α, IL-1β, and IL-6 would replicate the airway IgA response to injury.
Methods: : Experiment 1: male Institute of Cancer Research mice were randomized to uninjured controls (n = 8) or to surgical stress with laparotomy and neck incisions, with killing at 1, 2, 3, 5, or 8 hours after injury (n = 8/group). Bronchoalveolar lavage (BAL) and serum levels of TNF-α, IL-1β, and IL-6 were analyzed by enzyme-linked immunosorbent assay. Experiment 2: male Institute of Cancer Research mice were randomized to uninjured controls (n = 6), injury (surgical stress that was similar to experiment 1 except the peritoneum was left intact, n = 6), or cytokine injection with intraperitoneal injection of recombinant TNF-α, IL-1β, and IL-6. Animals were killed at 2 hours after injury, and nasal airway lavage and BAL IgA were analyzed by enzyme-linked immunosorbent assay.
Results: : Experiment 1: BAL TNF-α, IL-1β, and IL-6 levels increased in bimodal pattern after injury at 3 hours and 8 hours versus controls (p < 0.05). Serum IL-6 did not increase at 3 hours, but did show a significant increase by 5 hours versus control (p < 0.05). Serum levels of TNF-α and IL-1β did not change. Experiment 2: both Injury and combination TNF-α, IL-1β, and IL-6 cytokine injection significantly increased IgA levels in airway lavage (BAL + nasal airway lavage) compared with control (p < 0.01 for both).
Conclusions: : Airway levels of TNF-α, IL-1β, and IL-6 increase in a bimodal pattern after injury with peaks at 3 hours and 8 hours, which do not correspond to serum changes. The peak at 8 hours is consistent with the known increase in airway IgA after injury. Intraperitoneal injection of a combination exogenous TNF-α, IL-1β, and IL-6 replicates the airway IgA increase after injury. This effect is not seen with individual cytokine injections.
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References
-
- Vincent J. Ventilator-associated pneumonia. J Hosp Infect. 2004;57:272–280. - PubMed
-
- Cook D, Walter S, Cook R, et al. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med. 1998;129:433–440. - PubMed
-
- Cavalcanti M, Ferrer M, Ferrer R, et al. Risk and prognostic factors of ventilator-associated pneumonia in trauma patients. Crit Care Med. 2006;34:1067–1072. - PubMed
-
- Baker A, Meredith J, Haponik E. Pneumonia in intubated trauma patients. Microbiology and outcomes. Am J Respir Crit Care Med. 1996;153:343–349. - PubMed
-
- Rodriguez J, Gibbons K, Bitzer L, et al. Pneumonia: incidence, risk factors, and outcome in injured patients. J Trauma. 1991;31:907–912. discussion 912–904. - PubMed
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