The Correlation Between SIRS Caused By Wasp Sting Injuryand IL-6 Serum Level And Its Gene Polymorphism

Background:Wasp sting injury mainly occurred in the mountainous and hilly areas in summer and autumn.Wasp venom contains allergens and toxins,which can cause allergic and toxic reaction.Anaphylaxis is easy to cure,but toxic reactions often involving the heart,liver,kidney and other organs,thus,toxic reactions can easily lead to muLtiple organ dysfunction syndrome(MODS),and the prognosis of the patients is poor and with a high mortality.As the key to MODS is systemic inflammatory reaction syndrome(SIRS)cascade,interleukin-6(IL-6)is a muLtifunctional cytokine that plays an important role in the development of SIRS,therefore,the level of serum IL-6 may be related to wasp sting disease.On the other hand,in clinical work,the severity and prognosis of wasp sting is significantly different in almost the same degree of wasp sting patients,this suggests that the individual genetic background may be related to wasp sting disease.But whether the IL-6 gene polymorphism is related to wasp sting disease is not clear,our study researched the correlation between IL-6 and SIRS caused by wasp sting injury in protein expression and gene level,and we also analyze the risk factors in wasp sting patients with SIRS to provide new ideas for understanding the pathogenic mechanism of wasp sting and a theoretical basis for clinicians to avoid the occurrence of MODS.Objective: To investigate the expression of serum IL-6 level in wasp sting injury patients,whether IL-6 can be used to evaluate the severity of wasp sting.To study the relationship between serum IL-6 level and its promoter region gene polymorphism,looking for the predisposing genes and risk factors in SIRS patients caused by wasp sting injury to provide new ideas for understanding the pathogenic mechanism of wasp sting and a theoretical basis for clinicians to avoid the occurrence of muLtiple organ failure.Methods: All the wasp sting patients were divided into SIRS group and non-SIRS group(control group),we used enzyme linked immunosorbent assay(ELISA)to detect the serum IL-6 levels of the two groups,the whole genomic DNA was extracted from anticoaguLant peripheral venous blood,and amplifiedthe target fragments which contained IL-6-174G/C,-572G/C,-597G/A and-634C/G sites by polymerase chain reaction(PCR)technology,and sent them to Sangon Biotech(Shanghai)Co.,Ltd.for direct bidirectional DNA sequencing.The sequencing resuLts were compared with the nucleotide sequences in Gene bank and the location of SNP corresponding to the sequencing map was identified and genotyping was performed.ResuLts:(1)The serum IL-6 levels in SIRS group was significantly higher than in control group(P < 0.01).(2)There was no polymorphism in-174G/C,-597G/A and-634C/G sites of IL-6 gene promoter in Shiyan area or the frequency is very low,there were three genotypes of CC,GC and GG in-572G/C site.The distribution of genotypes in the control group was in accordance with the Hardy-Weinberg balance(P > 0.05).The frequencies of genotypes and alleles between the two groups were statistically different(P < 0.01).In G allele carriers,the serum IL-6 level was higher,and the difference was statistically significant(P < 0.01).(3)Non-conditional logistics regression analysis showed that the G allele was a predisposing gene for SIRS development in patients,the G carrier's risk ratio to have SIRS was 3.909 times than not G carrier's in wasp sting patients(OR = 3.909,95% CI = 1.906-8.019,P < 0.01)and more than 10 sting number was also a risk factor for SIRS development(OR = 3.342,95%CI = 1.570-7.113,P < 0.01).Conclusion: The serum IL-6 level can be used as a predictor of whether wasp sting patients will have SIRS,and the expression level of IL-6 was associated with-572G/C polymorphism,allele G and sting number reached 10 or more were the risk factors of SIRS development in wasp sting patients.IL-6-174G/C-597G/A and-634C/G sites may not exist in Shiyan popuLation or the frequency is very low.