Immediate IL-10 expression following major orthopaedic trauma: relationship to anti-inflammatory response and subsequent development of sepsis

Intensive Care Med. 2000 Aug;26(8):1076-81. doi: 10.1007/s001340051320.


Objective: To assess the relationship between IL-10 release and anti-inflammatory response following blunt trauma.

Design: Prospective longitudinal clinical study.

Setting: Departments of trauma and anaesthetics in a university teaching hospital.

Patients: Forty-eight adult patients with a mean injury severity score of 14.5 (range 9-57) were prospectively studied following blunt trauma.

Measurements and results: Venous blood samples were collected on arrival and at 16 and 24 h, and at 3, 5, and 7 days. Peripheral blood mononuclear cell (HLA-DR) expression on CD14 + monocytes was quantified by flow cytometry and serum IL-10 was assayed by ELISA. Anti-inflammatory response was defined as monocyte HLA-DR expression of less than 30% of that seen in healthy controls. Serum IL-10 levels in trauma patients on arrival was significantly elevated, 70.0 [48.0-92.1, 95% confidence interval, (CI)] compared to the control group, 3 (0-5) (P < 0.0001), and monocyte HLA-DR expression was significantly lower, 14.2 (12.1-16.3, 95% CI), in patients versus 25.2 (22.4-28.1) in controls (P < 0.001). Patients with low HLA-DR expression (n = 14) had significantly higher serum IL-10 levels than those whose HLA-DR expression remained above 30% of the control value (n = 34), (P < 0.038). In patients who developed sepsis (n = 11), serum IL-10 levels were greater on admission, [143.7 (80.2-207.2) pg/ml(-1)], and remained elevated during the study period compared with non-complicated patients, [50.16 (33.5-66.8) pg/ml(-1)]. Immediate IL-10 (2 h following trauma) was negatively correlated with simultaneous HLA-DR expression, (r = -0.49, P = 0.0005).

Conclusion: These findings support the view that IL-10 release regulates monocyte HLA-DR expression and may be related to an anti-inflammatory response and development of sepsis following trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Case-Control Studies
  • HLA-DR Antigens / blood
  • Humans
  • Injury Severity Score
  • Interleukin-10 / blood*
  • Middle Aged
  • Prospective Studies
  • Sepsis / etiology
  • Sepsis / immunology*
  • Time Factors
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / immunology*


  • HLA-DR Antigens
  • Interleukin-10