Cacaito, appreciate your correcting and expanding upon your earlier post. You may find the following abstract (emphasis mine) to be of interest:
JAMA 1995 Jul 12;274(2):172-7
Natural cytokine antagonists and endogenous antiendotoxin core antibodies in sepsis
syndrome. The Sepsis Intervention Group.
Goldie AS, Fearon KC, Ross JA, Barclay GR, Jackson RE, Grant IS, Ramsay G, Blyth AS, Howie JC
University Department of Surgery, Royal Infirmary, Edinburgh, Scotland.
OBJECTIVE--To assess the value of measuring circulating concentrations of mediators (endotoxin, tumor necrosis factor-alpha [TNF-alpha], interleukin-1
beta [IL-1 beta], and interleukin-6[IL-6]) and their endogenous antagonists (antiendotoxin core antibody [EndoCAb], interleukin-1 receptor antagonist
[IL-1ra], and soluble TNF receptors [sTNF-R]) in predicting mortality and organ failure in sepsis syndrome. DESIGN--Cohort study with a follow-up period
of 30 days. SETTING--Intensive therapy units of five tertiary referral centers in Scotland. SUBJECTS--A total of 146 intensive therapy unit patients with
sepsis syndrome underwent repeated sampling during a 10-day period following admission to an intensive therapy unit. MAIN OUTCOME
MEASURES--Circulating concentrations of mediators and antagonists were compared in survivors and nonsurvivors. RESULTS--Median Acute Physiology
and Chronic Health Evaluation II score was 23 (range, 8 to 40). Mortality at 30 days was 49%. On entry to the study, circulating endotoxin was detected in
66% of patients, TNF-alpha in 14%, and IL-1 beta in 29%. Levels did not predict mortality or organ failure. Patients with IL-6 concentrations in excess of
3000 pg/mL had an increased mortality rate (64% vs 40%, P = .02). The incidence of IgG EndoCAb depletion on entry to the study was 26% in nonsurvivors
and 10% in survivors (P = .02). Initial concentrations of both type I and type II sTNF-R were significantly higher in nonsurvivors (P < .01). Initial circulating
IL-1ra concentrations were not of value in predicting mortality. Cytokine antagonists were present in concentrations 30- to 100,000-fold greater than their
corresponding cytokine. CONCLUSION--The observed high circulating levels of the cytokine antagonists IL-1ra and sTNF-R and the relatively small
proportion of patients developing EndoCAb depletion may contribute to the limitations of therapies that aim to augment natural defenses against endotoxin or the proinflammatory cytokines.
PMID: 7596007, UI: 95319031 |
