Delayed neutralization of interleukin 6 reduces organ injury, selectively suppresses inflammatory mediator, and partially normalizes immune dysfunction following trauma and hemorrhagic shock

Shock. 2014 Sep;42(3):218-27. doi: 10.1097/SHK.0000000000000211.

Abstract

An excessive and uncontrolled systemic inflammatory response is associated with organ failure, immunodepression, and increased susceptibility to nosocomial infection following trauma. Interleukin 6 (IL-6) plays a particularly prominent role in the host immune response after trauma with hemorrhage. However, as a result of its pleiotropic functions, the effect of IL-6 in trauma and hemorrhage is still controversial. It remains unclear whether suppression of IL-6 after hemorrhagic shock and trauma will attenuate organ injury and immunosuppression. In this study, C57BL/6 mice were treated with anti-mouse IL-6 monoclonal antibody immediately prior to resuscitation in an experimental model combining hemorrhagic shock and lower-extremity injury. Interleukin 6 levels and signaling were transiently suppressed following administrations of anti-IL-6 monoclonal antibody following hemorrhagic shock and lower-extremity injury. This resulted in reduced lung and liver injury, as well as suppression in the levels of key inflammatory mediators including IL-10, keratinocyte-derived chemokine, monocyte chemoattractant protein 1, and macrophage inhibitory protein 1α at both 6 and 24 h. Furthermore, the shift to TH2 cytokine production and suppressed lymphocyte response were partly prevented. These results demonstrate that IL-6 is not only a biomarker but also an important driver of injury-induced inflammation and immune suppression in mice. Rapid measurement of IL-6 levels in the early phase of postinjury care could be used to guide IL-6-based interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antibodies, Monoclonal / pharmacology*
  • Antibodies, Neutralizing / pharmacology*
  • Cell Proliferation / drug effects
  • Cells, Cultured
  • Disease Models, Animal
  • Femoral Fractures / complications
  • Femoral Fractures / drug therapy*
  • Femoral Fractures / immunology
  • Femoral Fractures / metabolism
  • Hindlimb
  • Immune Tolerance / drug effects
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism*
  • Interleukin-6 / antagonists & inhibitors*
  • Interleukin-6 / immunology
  • Interleukin-6 / metabolism
  • Liver Diseases / immunology
  • Liver Diseases / metabolism
  • Liver Diseases / prevention & control*
  • Lung Injury / immunology
  • Lung Injury / metabolism
  • Lung Injury / prevention & control*
  • Lymphocyte Activation / drug effects
  • Male
  • Mice, Inbred C57BL
  • Shock, Hemorrhagic / complications
  • Shock, Hemorrhagic / drug therapy*
  • Shock, Hemorrhagic / immunology
  • Shock, Hemorrhagic / metabolism
  • Signal Transduction / drug effects
  • Systemic Inflammatory Response Syndrome / immunology
  • Systemic Inflammatory Response Syndrome / metabolism
  • Systemic Inflammatory Response Syndrome / prevention & control*
  • Th1 Cells / drug effects
  • Th1 Cells / immunology
  • Th1 Cells / metabolism
  • Th2 Cells / drug effects
  • Th2 Cells / immunology
  • Th2 Cells / metabolism
  • Tibial Fractures / complications
  • Tibial Fractures / drug therapy*
  • Tibial Fractures / immunology
  • Tibial Fractures / metabolism
  • Time Factors

Substances

  • Antibodies, Monoclonal
  • Antibodies, Neutralizing
  • Inflammation Mediators
  • Interleukin-6
  • interleukin-6, mouse