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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

, 23:96

First Online: 11 November 2015Received: 13 March 2015Accepted: 29 October 2015


IntroductionThe susceptibility to adverse outcome from critical injury occurrence of sepsis, septic shock, organ dysfunction-failure, and mortality varies dramatically due to different degrees of inflammatory response. We assessed the relationship of the genotype distribution of various cytokine gene polymorphisms CGP with regard to the development of sepsis, organ dysfunction or mortality in severely injured patients.

MethodObservational, hospital-based cohort study of 114 severely injured North Indian patients from New Delhi admitted to the Emergency Department ED of Trauma Centre, AIIMS. Patients were monitored from day first to discharge or death, measuring SOFA score, sepsis and septic shock occurrences up to one month. We have analyzed 13 cytokine genes, including the SNPs of structural and regulatory regions at 22 positions.

ResultsSequence-specific primer based PCR indicated that eight polymorphic loci IL-1α -889, IL-1β-511, IL-1R pstI 1970, TGF-β- code 10, TNF-α-308, TNF-α-238, IL-6-+565 and IL-10-1082, out of 22 SNPs are significantly associated with sepsis morbidity and outcome. Theses SNPs might be used as risk determinants of the outcome. Patients with IL-10 −1082A-A genotypes were found significantly higher in post traumatic sepsis patients and had a significantly higher risk to developed sepsis complication p < 0.05, OR = 0.86, C.I = 0.08-8.8.In case of TNF-α −308 position, GA and GG genotype patients have a significantly lower risk of poor outcome p < 0.05, OR = 0.25, C.I = 0.01-1.3 and p < 0.05, OR = 0.22, C.I = 0.01-0.5 in comparison to AA genotype. In this study, two polymorphisms IL-1β −511 and IL-1R were significantly associated with the development of MOF and mortality, where as IL-1α −889 polymorphism associated with susceptibility for sepsis. The distribution of haplotypes of TGF-β and IL-6 were also associated with sepsis susceptibility and outcome.

ConclusionIn conclusion, we have found that the alternations in the genotype and allele frequency of IL-1β −511C-T, TNF-α −308 G-A, TNF-α −238 G-A and IL-10 −1082 G-A genes are associated with an higher risk of sepsis development in trauma patients and outcomes.

AbbreviationsISSInjury severity score

MOFMultiple organ failure

S.IShock Index

SIRSSystemic Inflammatory response syndrome

SOFASequential Organ Failure Assessment score

THSTrauma hemorrhagic shock

SASSSepsis and septic shock

Electronic supplementary materialThe online version of this article doi:10.1186-s13049-015-0174-3 contains supplementary material, which is available to authorized users.

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Autor: Dablu Lal Gupta - Predeep Kumar Nagar - Vineet Kumar Kamal - Sanjeev Bhoi - D. N. Rao


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