Intensive Care Medicine

, Volume 34, Issue 4, pp 683–691 | Cite as

The human response to infection is associated with distinct patterns of interleukin 23 and interleukin 27 expression

  • Michael J. O’Dwyer
  • Arun K. Mankan
  • Mary White
  • Mathew W. Lawless
  • Patrick Stordeur
  • Brian O’Connell
  • Dermot P. Kelleher
  • Ross McManus
  • Thomas Ryan



The development and progression of severe sepsis is related to a deficiency in pro-inflammatory cytokine production, characterised by lesser IFNγ levels, which are not explained by variations in levels of the main putative regulator of IFNγ, namely IL-12. As alternative regulators of IFNγ may be of greater importance in human sepsis, we investigated the hypothesis that the development of severe sepsis is related to variations in IL-18, IL-23 and IL-27 gene expression.

Design and setting

A prospective observational trial in a mixed intensive care unit (ICU) and hospital wards in a university teaching hospital.

Patients and participants

Sixty-two ICU patients with severe sepsis, 13 bacteraemic patients with no acute critical illness, and 10 healthy controls.

Measurements and results

All subjects were assayed for IL-18, IL-23 and IL-27 mRNA levels in peripheral blood. IL-27 mRNA levels distinguished between the three groups, with levels highest in the ICU group, intermediate in the bacteraemic group and lowest in the control group. IL-23 distinguished between the groups, with levels lowest in the ICU group. In late sepsis IL-23 and TNFα mRNA levels were directly related. IL-18 mRNA levels did not distinguish between the patient groups.


We conclude that the deficient pro-inflammatory response in patients with sepsis is expansive and includes deficient IL-23 and excessive IL-27 gene expression. This provides further evidence that upregulation of a cytokine-based immune response is beneficial in sepsis.


Sepsis syndrome Cytokines Reverse transcriptase polymerase chain reaction Helper T-cells 

Supplementary material

134_2007_968_MOESM1_ESM.doc (32 kb)
Electronic Supplementary Material (DOC 32K)


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Michael J. O’Dwyer
    • 1
    • 2
  • Arun K. Mankan
    • 2
  • Mary White
    • 1
  • Mathew W. Lawless
    • 2
  • Patrick Stordeur
    • 3
  • Brian O’Connell
    • 4
  • Dermot P. Kelleher
    • 2
  • Ross McManus
    • 2
  • Thomas Ryan
    • 1
  1. 1.Department of AnaesthesiaSt James’s HospitalDublinIreland
  2. 2.Department of Clinical MedicineTrinity CollegeDublinIreland
  3. 3.Department of Immunology-Haematology-Transfusion, Hôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
  4. 4.Department of Clinical MicrobiologySt James’s HospitalDublinIreland

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