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Am. J. Respir. Crit. Care Med., Volume 162, Number 5, November 2000, 1877-1883

NF-kappa B Expression in Mononuclear Cells of Patients with Sepsis Resembles That Observed in Lipopolysaccharide Tolerance

MINOU ADIB-CONQUY, CHRISTOPHE ADRIE, PIERRE MOINE, KARIM ASEHNOUNE, CATHERINE FITTING, MICHAEL R. PINSKY, JEAN-FRANÇOIS DHAINAUT, and JEAN-MARC CAVAILLON

Unité d'Immuno-Allergie, Institut Pasteur, Paris, France; Service de Réanimation Médicale, Hôpital Cochin Port-Royal, Paris, France; Département d'Anesthésie Réanimation, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France; and Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

The expression of NF-kappa B was studied in freshly isolated peripheral blood mononuclear cells (PBMC) of patients with severe sepsis and major trauma. The expression of p65p50 heterodimer, the active form of NF-kappa B, was significantly reduced for all patients as compared with control subjects. The p50p50 homodimer, an inhibitory form of NF-kappa B, was reduced in the survivors of sepsis and in patients with trauma. Subsequent in vitro stimulation of PBMC with lipopolysaccharide (LPS) did not induce further NF-kappa B nuclear translocation: the survivors of sepsis and trauma patients showed low expression of both p65p50 and p50p50, whereas nonsurvivors of sepsis showed a predominance of the inactive homodimer and a low p65p50/p50p50 ratio when compared with control subjects. In the later group of patients there was a reverse correlation between plasma IL-10 levels and the p65p50/p50p50 ratio after in vitro LPS stimulation (r = -0.8, p = 0.04). The reduced expression of nuclear NF-kappa B was not due to its inhibition by Ikappa Balpha , as very low expression of Ikappa Balpha , as well as low levels of p65 and p50 were found in the cytoplasm of PBMC from patients with sepsis and trauma when compared with control subjects. These results demonstrate that upon LPS activation, PBMC of patients with systemic inflammatory response syndrome show patterns of NF-kappa B expression that resemble those reported during LPS tolerance: global down-regulation of NF-kappa B in survivors of sepsis and trauma patients and the presence of large amounts of the inactive homodimer in the nonsurvivors of sepsis.




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