Identification of biomarkers of response to IFNg during endotoxin tolerance: application to septic shock

PLoS One. 2013 Jul 11;8(7):e68218. doi: 10.1371/journal.pone.0068218. Print 2013.

Abstract

The rapid development in septic patients of features of marked immunosuppression associated with increased risk of nosocomial infections and mortality represents the rational for the initiation of immune targeted treatments in sepsis. However, as there is no clinical sign of immune dysfunctions, the current challenge is to develop biomarkers that will help clinicians identify the patients that would benefit from immunotherapy and monitor its efficacy. Using an in vitro model of endotoxin tolerance (ET), a pivotal feature of sepsis-induced immunosuppression in monocytes, we identified using gene expression profiling by microarray a panel of transcripts associated with the development of ET which expression was restored after immunostimulation with interferon-gamma (IFN-γ). These results were confirmed by qRT-PCR. Importantly, this short-list of markers was further evaluated in patients. Of these transcripts, six (TNFAIP6, FCN1, CXCL10, GBP1, CXCL5 and PID1) were differentially expressed in septic patients' blood compared to healthy blood upon ex vivo LPS stimulation and were restored by IFN-γ. In this study, by combining a microarray approach in an in vitro model and a validation in clinical samples, we identified a panel of six new transcripts that could be used for the identification of septic patients eligible for IFNg therapy. Along with the previously identified markers TNFa, IL10 and HLA-DRA, the potential value of these markers should now be evaluated in a larger cohort of patients. Upon favorable results, they could serve as stratification tools prior to immunostimulatory treatment and to monitor drug efficacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cross Infection / blood
  • Cross Infection / genetics
  • Cross Infection / immunology
  • Drug Tolerance
  • Endotoxins / immunology*
  • Female
  • HLA-DR alpha-Chains / genetics
  • HLA-DR alpha-Chains / metabolism
  • Humans
  • Immune Tolerance / genetics
  • Immune Tolerance / immunology*
  • Immunosuppression Therapy / methods
  • Immunotherapy / methods
  • Interferon-gamma / immunology*
  • Interleukin-10 / genetics
  • Interleukin-10 / immunology
  • Lipopolysaccharides / immunology
  • Male
  • Middle Aged
  • Monocytes / immunology
  • Sepsis / blood
  • Sepsis / genetics
  • Sepsis / immunology*
  • Shock, Septic / blood
  • Shock, Septic / genetics
  • Shock, Septic / immunology*
  • Transcriptome
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Biomarkers
  • Endotoxins
  • HLA-DR alpha-Chains
  • IL10 protein, human
  • Lipopolysaccharides
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interferon-gamma

Grants and funding

GM, FV and AL were supported by the Hospices civils de Lyon. FAF, FTD, CM, ADSJ, VB, EC and AP were supported by bioMerieux. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.