The relationships between cytokine responses in septic shock are currently poorly
understood. Some studies have pointed to a biphasic model, with an initial proinflammatory
phase, followed by a reactive, anti-inflammatory response to explain the pathogenesis
of the most severe form of sepsis. However, evidence for the coexistence of both responses
has been found. In this study, the plasma levels of 17 cytokines and chemokines, in
20 patients with septic shock, 11 patients with systemic inflammatory response syndrome
(SIRS), during the first 24 hours following diagnosis, and 10 healthy controls, were
analyzed and compared. Patients with septic shock showed increased levels of IL-6,
IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and IL-10 compared to healthy controls. Patients
with SIRS showed higher levels of IL-6, IL-8, MCP-1, MIP-1β, G-CSF and IL-10 than
controls. Patients with septic shock showed higher levels of IL-8, GM-CSF, MIP-1β
than those with SIRS. The Spearman test demonstrated a positive association between
the pro-inflammatory mediators IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and the immunomodulatory
cytokine IL-10 in septic shock. Consequently, correlation studies supported the notion
that secretion of pro- and anti-inflammatory mediators in septic shock occurs as a
simultaneous immune response program initiated early in the course of the disease,
revealing that both types of cytokine play a role from the very beginning of this
life-threatening condition.