An increased ratio of plasma IL-10 to TNF-α levels is a risk factor for the occurrence of septic shock in children with infectious diseases

Background : Cytokine storm contributes to the pathogenesis of septic shock and is a risk factor for unfavorable prognosis in patients with infectious diseases. This retrospective case-control study aimed to investigate whether a ratio of plasma interleukin-10 (IL-10) to tumor necrosis factor-alpha (TNF-α) levels (IL-10/TNF-α) could serve as a biomarker for assessing the occurrence of septic shock in children with infectious diseases. Methods : The demographic and clinical data were collected from 122 hospitalized children with suspected sepsis and they were classified into the infectious, sepsis and septic shock groups, based on the diagnostic criteria. Their plasma IL-10 and TNF-α levels were measured on days 1 and 5. The relationship between plasma IL-10, TNF-α, and IL-10/TNF-α and the disease severities was analyzed. Results : The SOFA and PRISM scores on days 1 and 5 in the septic shock group (n=35) were significantly higher than that in the infectious group (n=65) and the sepsis group (n=22) ( p <0.05). Furthermore, plasma IL-10 and TNF-α levels and the IL-10/TNF-α in the septic shock group on day 1 were also significantly higher than that in the infectious and sepsis groups ( p <0.05). The plasma IL-10/TNF-α was positively correlated with severities of diseases and an independent risk factor for the onset of septic shock in this population ( p <0.05). Conclusions : These findings suggest that the plasma IL-10/TNF-α may be a valuable measure to predict the development of septic shock in children with infectious diseases.