OBJECTIVETo investigate the impact of monocyte releasing tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) stimulated by lipopolysaccharide (LPS) in severe sepsis (SS) patients, and the regulatory effect of emodin and Shenmai Injection (SMI) on monocyte response.

METHODSocyte (PBMC) sampled from SS patients due to severe abdominal inflammation and healthy controls, PBMC were incubated with or without LPS, respectively. PBMC media pretreated with emodin and SMI, and then the levels of cytokine factors including TNF-alpha and IL-10 in supernatants were determined after stimulated with or without LPS in the two groups. Normal PBMC stimulated with LPS based on incubated with either normal serum or SS serum, and the levels of TNF-alpha and IL-10 in supernatant of normal PBMC and SS serum dealing with emodin or SMI after cultured and stimulated with LPS were determined, respectively.

RESULTSThe levels of TNF-alpha and IL-10 were significantly higher in SS patients than those in the healthy adults. The contents of TNF-alpha and IL-10 increased in response to LPS in PBMC of healthy adults, and the excretion of TNF-alpha was significantly attenuated whereas IL-10 significantly increased in septic PBMC than basal content. Both of the two traditional Chinese medicines had significantly effect in stimulating PBMC secretion in healthy adults and SS patients. In normal PBMC, emodin attenuated TNF-alpha and IL-10 release in response to LPS, and SMI significantly inhibited TNF-alpha release. As to septic PBMC, emodin significantly stimulated TNF-alpha and IL-10 release and SMI significantly increased the concentration of TNF-alpha in the SS patients. Incubation of normal PBMC with septic serum attenuated TNF-alpha production, whereas increased IL-10 release. Emodin could significantly decrease the level of IL-10, and SMI recovered TNF-alphareleasing and had no effect on IL-10.

CONCLUSIONThe level of TNF-alpha significantly decreased accompanied with an anti-inflammatory cytokine IL-10 significantly increased of PBMC in SS patients. Monocyte exhibits the different response of inflammatory or anti-inflammatory factor which may be one of the reasons of imbalance of immune function in SS patients. Both of emodin and SMI may have regulatory effect on excretion of PBMC in SS patients, but they play a role in different ways.