COVID-19: Blood Biomarkers - Interleukin 10

IL10 - Interleukins ups and downs in COVID-19

Dicken Weatherby, N.D. and Beth Ellen DiLuglio, MS, RDN, LDN

Interleukin-10 is an anti-inflammatory cytokine that curbs IL-6, TNF-alpha, and IL-8 pro-inflammatory activity.[I]

The ODX COVID-19 Series

1. COVID-19: The pandemic that has become endemic
2. COVID-19: Overlapping risk factors and chronic disease
3. Nutritional status COVID-19: A covert factor in disease susceptibility
4. COVID-19: Blood chemistry biomarker patterns - Clues and patterns lurking just under the surface
5. COVID-19: Blood chemistry biomarker patterns - Down the research rabbit hole
6. COVID-19: Blood Biomarkers - Neutrophils
7. COVID-19: Blood Biomarkers - Albumin
8. COVID-19: BloodBiomarkers - Cytokines
9. COVID-19: Blood Biomarkers - Interleukin-6
10. COVID-19: Blood Biomarkers - Interleukin-10
11. COVID-19: Blood Biomarkers - Vitamin C
12. COVID-19: Blood Biomarkers - Vitamin D
13. COVID-19: Blood Biomarkers - Zinc
14. Biomarker characteristics and blood type - help sharpen the COVID-19 clinical picture
15. COVID-19: Initial indications and conventional interventions
16. COVID-19: Long-term risk reduction - Naturopathic, functional medicine, and nutrition-based approaches to prevention
17. A healthy diet is primary prevention for COVID-19
18. You should have a gut feeling about COVID-19
19. Beyond dietary food patterns…plant-based compounds may mitigate COVID-19 risk
20. Targeted nutrition support in the battle against COVID-19
21. Targeted nutrition support in COVID-19: Armed with vitamin C
22. Targeted nutrition support in COVID-19: In sync with zinc
23. Targeted nutrition support in COVID-19: Micronutrients and phytonutrients are important players
24. Optimal Takeaways for improving immunity and reducing susceptibility to COVID-19
25. Optimal - The Podcast: Episode 8 -Blood Biomarkers and Risk Factors for COVID-19 and its Comorbidities

Research suggests that it is instrumental in controlling autoimmunity and angiogenesis,[ii] resolving inflammation, and healing wounds.[iii] IL-10 is also the “most widely studied anti-inflammatory and pro-resolution cytokine” in acute ARDS.[iv]

During a cytokine storm, IL-10 induces an “immunoparalysis” that downregulates the function of neutrophils and monocytes. Short-term immunoparalysis may be beneficial but prolonged immunosuppression may contribute to mortality even in those who survive the initial cytokine storm.[v]

Standard reference range serum IL-10

• Labcorp[vi]7-23.3 pg/mL
  • Results for this test are for research purposes only by the assay's manufacturer. The performance characteristics of this product have not been established. Results should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.

Ratio of IL-6 to IL-10

Research suggests that evaluating the ratio of IL-6 to IL-10 may be more clinically useful than measuring either cytokine alone.

Evaluation of the IL-6 to IL-10 ratio has been used to predict the severity of injury in trauma patients. Early IL-6:IL-10 ratio of 3.11 correlated significantly with severity of injury and APACHI II scores.[vii]

Calculation of the ratio of IL-6:IL-10 was integrated into the “Dublin-Boston score” used to determine the severity of infection for hospitalized COVID-19 patients. Both the day four change in IL-6:IL-10 ratio as well as the linear Dublin-Boston score were more valuable in predicting clinical outcome at day seven than measuring IL-6 alone. Each 0.1 unit increase in IL-6:IL-10 ratio day 1-4 increased the odds of a more severe clinical outcome.[viii]        

Circulating cytokines reflect the underlying inflammatory battle that occurs with COVID-19. Failure to establish balanced cytokine profiles can lead to increased morbidity and mortality.

Next Up - COVID-19: Blood Biomarkers - Vitamin C

Research

[i] Rea, Irene Maeve et al. “Age and Age-Related Diseases: Role of Inflammation Triggers and Cytokines.” Frontiers in immunology vol. 9 586. 9 Apr. 2018, doi:10.3389/fimmu.2018.00586 

[ii] Labcorp. Serum IL-10. 

[iii] Burmeister, Amanda R, and Ian Marriott. “The Interleukin-10 Family of Cytokines and Their Role in the CNS.” Frontiers in cellular neuroscience vol. 12 458. 27 Nov. 2018, doi:10.3389/fncel.2018.00458 

[iv] McElvaney, Oliver J et al. “A linear prognostic score based on the ratio of interleukin-6 to interleukin-10 predicts outcomes in COVID-19.” EBioMedicine, vol. 61 103026. 8 Oct. 2020, doi:10.1016/j.ebiom.2020.103026 [R]

[v] Tisoncik, Jennifer R et al. “Into the eye of the cytokine storm.” Microbiology and molecular biology reviews : MMBR vol. 76,1 (2012): 16-32. doi:10.1128/MMBR.05015-11 

[vi] Labcorp. Serum IL-10. 

[vii] Taniguchi, T et al. “The ratio of interleukin-6 to interleukin-10 correlates with severity in patients with chest and abdominal trauma.” The American journal of emergency medicine vol. 17,6 (1999): 548-51. doi:10.1016/s0735-6757(99)90194-8

[viii] McElvaney, Oliver J et al. “A linear prognostic score based on the ratio of interleukin-6 to interleukin-10 predicts outcomes in COVID-19.” EBioMedicine, vol. 61 103026. 8 Oct. 2020, doi:10.1016/j.ebiom.2020.103026