Association between increased levels of IL‐2 and IL‐15 and outcome in patients with early acute respiratory distress syndrome

Agouridakis, Panagiotis; Kyriakou, Despina; Alexandrakis, Michael G.; Perisinakis, Kostas; Karkavitsas, Nikolaos; Bouros, Demosthenes

doi:10.1046/j.1365-2362.2002.01081.x

Cited by 20 publications

(16 citation statements)

References 37 publications

(35 reference statements)

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“…During ARDS, the alveolar epithelial-endothelial barrier is disrupted, and cytokines produced in the lung are released into the systemic circulation. This is believed to be a potential mechanism for the development of systemic inflammatory response syndrome [31,32]. The relationship between circulatory and pulmonary cytokines levels and outcome provides support to the hypothesis that poor outcome in ARDS is related to a persistent inflammatory process [30-33].…”

Section: Discussionmentioning

confidence: 91%

The clinical significance of serum and bronchoalveolar lavage inflammatory cytokines in patients at risk for Acute Respiratory Distress Syndrome

et al. 2004

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BackgroundThe predictive role of many cytokines has not been well defined in Acute Respiratory Distress Syndrome (ARDS).MethodsWe measured prospectively IL-4, IL-6, IL-6 receptor, IL-8, and IL-10, in the serum and bronchoalveolar lavage fluid (BALF) in 59 patients who were admitted to ICU in order to identify predictive factors for the course and outcome of ARDS. The patients were divided into three groups: those fulfilling the criteria for ARDS (n = 20, group A), those at risk for ARDS and developed ARDS within 48 hours (n = 12, group B), and those at risk for ARDS but never developed ARDS (n = 27, group C).ResultsAn excellent negative predictive value for ARDS development was found for IL-6 in BALF and serum (100% and 95%, respectively). IL-8 in BALF and IL-8 and IL-10 serum levels were higher in non-survivors in all studied groups, and were associated with a high negative predictive value. A significant correlation was found between IL-8 and APACHE score (r = 0.60, p < 0.0001). Similarly, IL-6 and IL-6r were highly correlated with PaO2/FiO2 (r = -0.27, p < 0.05 and r = -0.55, p < 0.0001, respectively).ConclusionsBALF and serum levels of the studied cytokines on admission may provide valuable information for ARDS development in patients at risk, and outcome in patients either in ARDS or in at risk for ARDS.

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Section: Discussionmentioning

confidence: 91%

The clinical significance of serum and bronchoalveolar lavage inflammatory cytokines in patients at risk for Acute Respiratory Distress Syndrome

et al. 2004

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“…In another study, Agouridakis et al [19] evaluated both the prognostic and predictive significance of IL-2 and IL-15 for the development and outcome of patients at risk who developed ARDS or patients at risk who never developed ARDS, respectively. They applied ROC curve analysis and showed an excellent predictive value of cytokine plasma levels in terms of specificity and sensitivity compared to those observed in BALF.…”

Section: Cytokines (Tables 2 and 3)mentioning

confidence: 99%

“…Finally, only the minority of the studies [18,19,25-27,43,45,47,51,53,64,66,67,83,86,95] clarified the effectiveness and the diagnostic accuracy of the biomarkers by applying ROC curve analysis which is essential to estimate the sensitivity and specificity of a marker and to introduce clinically practical cut-off levels for the prediction of ARDS development in at risk individuals.…”

Section: Future Challenges and Limitationsmentioning

confidence: 99%

Serum biomarkers in Acute Respiratory Distress Syndrome an ailing prognosticator

2005

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Serum biomarkersacute respiratory distress syndromeacute lung injurycytokinesKL-6surfactant proteinsadhesion molecules. AbstractThe use of biomarkers in medicine lies in their ability to detect disease and support diagnostic and therapeutic decisions. New research and novel understanding of the molecular basis of the disease reveals an abundance of exciting new biomarkers who present a promise for use in the everyday clinical practice. The past fifteen years have seen the emergence of numerous clinical applications of several new molecules as biologic markers in the research field relevant to acute respiratory distress syndrome (translational research). The scope of this review is to summarize the current state of knowledge about serum biomarkers in acute lung injury and acute respiratory distress syndrome and their potential value as prognostic tools and present some of the future perspectives and challenges.

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“…Because the syndrome is so heterogeneous in etiology and progression, clinical evaluation alone may not provide sufficient information to guide therapy (4). Although a number of serum proteins have been found to be diagnostically and prognostically relevant in patients with ARDS, these markers are not routinely available to clinicians (5–9). Thus, their utility in patient care is limited.…”

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confidence: 99%

Prognostic value of plasma N-terminal probrain natriuretic peptide levels in the acute respiratory distress syndrome*

Bajwa

Januzzi

Gong

et al. 2008

Critical Care Medicine

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Objective Patients with acute respiratory distress syndrome suffer from profound cardiac and pulmonary derangement, including right ventricular strain and noncardiogenic pulmonary edema, which may potentially alter concentrations of cardiac natriuretic peptides. We sought to determine whether N-terminal probrain natriuretic peptide (NT-proBNP) levels are elevated in acute respiratory distress syndrome and whether they can serve as a marker of prognosis in this setting. Design Prospective study. Setting Tertiary-care academic medical center. Patients One hundred seventy-seven acute respiratory distress syndrome subjects enrolled in a prospective intensive care unit cohort. Interventions None. Measurements and Main Results NT-proBNP was measured from blood taken within 48 hrs of acute respiratory distress syndrome onset. Patients were followed for the primary outcome of 60-day mortality and secondary outcomes of organ dysfunction and ventilator-free days. Seventy patients died (40%). Median NT-proBNP level was 3181 ng/L (interquartile range 723–9246 ng/L). NT-proBNP levels were significantly higher among nonsurvivors (p < .0001). Receiver operating curve analysis revealed an optimal NT-proBNP cut-point of 6813 ng/L for predicting death. Patients with levels above the cut-point had significantly higher odds of mortality on multivariable analysis (odds ratio 2.36, 95% confidence interval 1.11– 4.99, p = .02) than those with levels below the cut-point. Kaplan-Meier survival analysis showed that this difference emerged early and was sustained (p < .0001). Patients with elevated NT-proBNP also had higher organ dysfunction scores (p < .0001) and fewer ventilator free days (p = .03) than those with lower NT-proBNP levels. Conclusions NT-proBNP levels are elevated among acute respiratory distress syndrome patients and parallel the severity of the syndrome and likelihood for morbidity and mortality. This demonstrates the potential utility of this biomarker for prognosis in this disease.

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Association between increased levels of IL‐2 and IL‐15 and outcome in patients with early acute respiratory distress syndrome

Abstract: Determination of serum IL-2 and IL-15 levels may be a valuable and simple aid to improve identification of patients with ARDS or at risk for ARDS who are at high risk of subsequent mortality.

Cited by 20 publications

References 37 publications

The clinical significance of serum and bronchoalveolar lavage inflammatory cytokines in patients at risk for Acute Respiratory Distress Syndrome

The clinical significance of serum and bronchoalveolar lavage inflammatory cytokines in patients at risk for Acute Respiratory Distress Syndrome

Serum biomarkers in Acute Respiratory Distress Syndrome an ailing prognosticator

Prognostic value of plasma N-terminal probrain natriuretic peptide levels in the acute respiratory distress syndrome*

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