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. 1990 Apr 1;77(4):401–404. doi: 10.1002/bjs.1800770415

Effect of low dose recombinant interleukin 2 plus indomethacin on mortality after sepsis in a murine burn model

P G Morgan 1,, J A Mannick 2, D B Dubravec 3, M L Rodrick 4,
PMCID: PMC11457739  PMID: 2340389

Abstract

Under anaesthesia, 129 8-week-old male A/J mice were subjected to a 25 per cent scald or sham burn and then resuscitated. They were divided at random into two groups. Mice from the first group were allocated into two groups. Mice from the first group were allocated into four subgroups to receive 6 days intraperitoneal (I.P.) injections as follows: (i) recombinant human interleukin 2 (rhIL-2) (250 units day−1); (ii) saline; (iii) indomethacin (5 µg−1 day−1); or (iv)rhlL-2 (250 units) + indomethacin (5 µg). Sham burned mice served as no treatment controls. All animals were subjected to peritonitis induced by caecal ligation and puncture 10 days after the burn and mortality was assessed. Mice from the second group were allocated to two subgroups to receive 6 days intraperitoneal injections of: (i) rhIL-2 + indomethacin; or (ii) saline. Animals in this group did not undergo septic challenge. They were randomly killed on days 7, 9 or 10 after the burn. Their splenocytes were harvested and assayed for response to the mitogens phytohaemagglutinin (PHA) and concanavalin A (Con A), and for production of interleukin 2. Mortality rate in animals subjected to burn and septic challenge without treatment was 75 per cent; in mice receiving rhIL-2 alone it was 68 per cent, in mice receiving indomethacin alone it was 62 per cent (no significance) and in mice receiving rhIL-2 + indomethacin it was reduced to 38 per cent (P < 0·02). Splenocytes from animals receiving combination therapy had markedly improved responses to PHA on days 7 (P = 0·01), 9 (P = 0·02), and 10 (P = 0·008), and to Con A on days 7 (P = 0·001), 9 (P = 0·002) and 10 (P = 0·001), after burn injury. Interleukin 2 production was also significantly (P = 0·004) improved by therapy with rhIL-2 + indomethacin. These data suggest that low dose rhIL-2 in combination with indomethacin may have potential use in the therapy of burn victims.

Keywords: Interleukin 2, burns, therapy

Contributor Information

P G Morgan, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA.

J A Mannick, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA.

D B Dubravec, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA.

Dr M L Rodrick, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA.

References

  • 1. Baker  CC, Oppenheimer  L, Stephens  B, Lewis  FR, Trunkey  DD. Epidemiology of trauma deaths. Am J Surg  1980; 140: 144–50. [DOI] [PubMed] [Google Scholar]
  • 2. Polk  HC. Concensus summary on infection. J Trauma  1979; 19: 894–6. [PubMed] [Google Scholar]
  • 3. Curreri  WP, Luterman  A, Braun  DW, Shires  GT. Burn injury. Analysis of survival and hospitalisation time for 937 patients. Ann Surg  1980; 192: 472–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4. Donati  L, Lazzarin  A, Signorini  A, McAndiana  P, Klinger  M, Morini  M. Preliminary experiences with use of immunomodulators in burns. J Trauma  1983; 23: 816–31. [PubMed] [Google Scholar]
  • 5. Alexander  JW, Ogle  CK, Stinnett  JD, MacMillan  BG. A sequential prospective analysis of immunological abnormalities and infection following severe thermal injury. Ann Surg  1978; 188: 809–16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6. Casson  P, Soloway  AC, Converse  JM, Rapaport  FT. Delayed hypersensitivity status of burned patients. Surg Forum  1966; 17: 268–70. [PubMed] [Google Scholar]
  • 7. Markley  K. The role of bacteria in burn mortality. Ann N Y Acad Sci  1968; 5: 922–30. [DOI] [PubMed] [Google Scholar]
  • 8. Warden  JD, Mason  AD, Pruitt  BA. Evaluation of leukocyte chemotaxis in vitro in thermally injured patients. J Clin Invest  1974; 54: 1001–4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Wolfe  JHN, Wu  AVO, O'Connor  NE, Saporoschetz  I, Mannick  JA. Anergy, immunosuppressive serum and impaired lymphocyte blastogenesis in burn patients. Arch Surg  1982; 117: 1266–71. [DOI] [PubMed] [Google Scholar]
  • 10. Antonacci  AC, Good  RA, Gupta  S. T-cell subpopulations following thermal injury. Surg Gynecol Obstet  1982; 155: 1–8. [PubMed] [Google Scholar]
  • 11. Kupper  TS, Baker  CC, Ferguson  TA, Green  DR. A burn induced LY-2 suppressor T-cell lowers resistance to bacterial infection. J Surg Res  1985; 38: 606–12. [DOI] [PubMed] [Google Scholar]
  • 12. Ninneman  JL, Ozkan  AN. Definition of a burn injury induces immunosuppressive serum component. J Trauma  1985; 25: 113. [DOI] [PubMed] [Google Scholar]
  • 13. Schoenenberger  GA, Burckhardt  F, Kalberer  F  et al.  Experimental evidence for a significant impairment of host defence for Gram-negative organisms by a specific cutaneous toxin produced by severe thermal injuries. Surg Gynecol Obstet  1975; 141: 555–61. [PubMed] [Google Scholar]
  • 14. Wolfe  JHN, Saporotchetz  I, Young  AE, O'Connor  NE, Mannick  JA. Serum, suppressor lymphocytes and death from burns. Ann Surg  1981; 193: 513–20. [PMC free article] [PubMed] [Google Scholar]
  • 15. Morgan  PG, Rodrick  ML, Ellwanger  KC, Collins  KA, Dubravec  DB, Mannick  JA. In vivo effects of an immunosuppressive factor isolated from patients following thermal injury. Surg Forum  1988; 39: 167–70. [Google Scholar]
  • 16. Wood  JJ, Rodrick  ML, O'Mahony  JB  et al.  Impaired production of interleukin 2. A fundamental immunological deficiency in patients with major burns. Surgery  1984; 200: 311–20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17. Gough  DB, Moss  NM, Jordan  A, Grbic  JT, Rodrick  ML, Mannick  JA. Recombinant interleukin 2 (rhIL-2) improves immune response and host defence to septic challenge in thermally injured mice. Surgery  1988; 104: 292–300. [PubMed] [Google Scholar]
  • 18. Lotze  MT, Frana  LW, Sharrow  SO, Robb  RJ, Rosenberg  SA. In vivo administration of purified human interleukin 2. 1. Half-life and immunologic effects of the Jurkat cell line-derived interleukin 2. J Immunol  1985; 134: 157–66. [PubMed] [Google Scholar]
  • 19. Chouaib  S, Chatenoud  L, Klatzmann  D, Fradelizi  D. The induction mechanisms of inhibition of human IL-2 production. II. PGE2 of suppressor T lymphocytes. J Immunol  1979; 132: 1851–7. [PubMed] [Google Scholar]
  • 20. Grbic  JT, Wood  JJ, Jordan  A, Rodrick  ML, Mannick  JA. Lymphocytes from burn patients are more sensitive to suppression by prostaglandin E2. Surg Forum  1985; 36: 108–9. [Google Scholar]
  • 21. Gillis  B, Perm  MM, Ou  W, Smith  KA. T-cell growth factor: parameters of production and a quantitative microassay for activity. J Immunol  1978; 120: 2027–32. [PubMed] [Google Scholar]
  • 22. Fusi  SF, Kupper  TS, Green  DR, Ariyan  S. Reversal of post burn immunosuppression by the administration of Vitamin A. Surgery  1984; 84: 330–3. [PubMed] [Google Scholar]
  • 23. Waymack  JP, Miskell  P, Gonse  SJ, Alexander  JW. Immunomodulators in the treatment of peritonitis in burned and malnourished animals. Surgery  1984; 96: 308–14. [PubMed] [Google Scholar]
  • 24. Munster  AM, Winshurch  RA, Thupari  JN, Ernst  CP. Reversal of post burn immunosuppression with low dose polymyxin B. J Trauma  1986; 26: 995–8. [DOI] [PubMed] [Google Scholar]
  • 25. Zapata-Sirvent  RL, Hansbrough  JF, Bender  EM, Bartle  EJ, Monsour  M, Carter  WH. Post burn immunosuppression in an animal model. 4. Improved resistance to septic challenge with immunomodulating drugs. Surgery  1986; 99: 53–8. [PubMed] [Google Scholar]
  • 26. Hansbrough  J, Peterson  V, Zapata-Sirvent  R, Claman  HN. Post burn immunosuppression in an animal model. 2. Restoration of cell mediated immunity by immunomodulating drugs. Surgery  1984; 95: 290–5. [PubMed] [Google Scholar]
  • 27. Fulton  AM, Levy  JG. The possible role of prostaglandins in mediating immune suppression by non-specific T-suppressor cells. Cell Immunol  1980; 52: 29–37. [DOI] [PubMed] [Google Scholar]
  • 28. Webb  DR, Rogers  TH, Nowowiejski  I. Endogenous prostaglandin synthesis and control of lymphocyte function. Ann NY Acad Sci  1979; 332: 262–70. [DOI] [PubMed] [Google Scholar]
  • 29. Arturson  G. Prostaglandins in human burn wound secretion. Burns  1977; 3: 112–18. [Google Scholar]
  • 30. De Shazo  RD. Indomethacin responsive mononuclear cell function in Hodgkin's disease. Clin Immunol Immunopathol  1980; 17: 66–75. [DOI] [PubMed] [Google Scholar]
  • 31. Webb  DR, Osheroff  DL. Antigen stimulation of prostaglandin synthesis and control of immune responses. Proc Natl Acad Sci USA  1976; 73: 1300–4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32. Webb  DR, Jamieson  AT. Control of mitogen induced transformation: characterisation of a splenic suppressor cell and its mode of action. Cell Immunol  1976; 24: 45–57. [DOI] [PubMed] [Google Scholar]
  • 33. Hansbrough  JF, Peterson  V, Kortz  E  et al.  Post burn immunosuppression in an animal model: monocyte dysfunction induced by burned tissue. Surgery  1983; 93: 415–23. [PubMed] [Google Scholar]
  • 34. Miller  SE, Miller  CL, Trunkey  DD. The immune consequences of trauma. Surg Clin North Am  1982; 62: 167–82. [DOI] [PubMed] [Google Scholar]
  • 35. Latter  DA, Tchervenkou  JI, Nohr  CV, Christou  NV. The effect of indomethacin on burn induced immunosuppression. J Surg Res  1987; 43: 246–52. [DOI] [PubMed] [Google Scholar]
  • 36. Grbic  JT, Wood  JJ, Jordan  A  et al.  Lymphocytes from burn patients are more sensitive to suppression by prostaglandin E2. Surg Forum  1985; 36: 108–9. [Google Scholar]
  • 37. Robb  RJ. Interleukin 2: the molecule and its function. Immunol Today  1984; 5: 203–9. [DOI] [PubMed] [Google Scholar]
  • 38. Rosenberg  SA, Lotze  MT, Muul  LM  et al.  Progress report on the treatment of 157 patients with advanced cancer using lymphokine activated killer cells and interleukin 2 or high dose interleukin 2 alone. N Engl J Med  1987; 316: 889–97. [DOI] [PubMed] [Google Scholar]

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