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Critical Care
Published in: Critical Care 4/2008

Open Access 01-08-2008 | Research

Hyperosmotic stress enhances cytokine production and decreases phagocytosis in vitro

Authors: Natalie M Otto, Ralf Schindler, Andreas Lun, Olaf Boenisch, Ulrich Frei, Michael Oppert

Published in: Critical Care | Issue 4/2008

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Abstract

Introduction

Hyperglycemia is associated with negative outcomes in various settings of critical illness; infectious complications, especially, seem to be increased. On the other hand, intensive insulin therapy (IIT) has been shown to improve outcome in clinical trials. Whether normoglycemia itself or the application of insulin is responsible for the observed findings is unknown. We therefore tested the effect of glucose and insulin on various immune functions in vitro.

Methods

Human peripheral blood mononuclear cells (PBMCs) were incubated ex vivo with low doses of lipopolysaccharide (LPS). PBMCs were incubated with various osmotic agents, insulin, or a combination of both. Interleukin (IL)-6 and IL-1 cytokine response was measured by enzyme-linked immunosorbent assay. In addition, we investigated the effects of glucose on phagocytosis and oxidative burst in human granulocytes.

Results

Increasing concentrations of both glucose and mannitol significantly enhanced LPS-induced cytokine production. Insulin alone did not alter cytokine production and had only a minor influence in combination with glucose. Phagocytosis and oxidative burst were significantly reduced with increasing concentrations of glucose and mannitol.

Conclusion

Hyperglycemia may lead to inflammation by enhancing cytokine production via the direct effects of hyperosmotic stress. Impaired phagocytosis and oxidative burst under hyperglycemia may weaken defense mechanisms of the host. Our in vitro findings may help to explain the beneficial effects of IIT not only in diabetic but also in critically ill patients.
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Metadata
Title
Hyperosmotic stress enhances cytokine production and decreases phagocytosis in vitro
Authors
Natalie M Otto
Ralf Schindler
Andreas Lun
Olaf Boenisch
Ulrich Frei
Michael Oppert
Publication date
01-08-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6989

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