Cytokine profiles linked to fatal outcome in infective prosthetic valve endocarditis

Abstract

Infective endocarditis is a disease normally of bacterial cause which affects the endocardic tissue, specifically the valves (native or prosthetic). It is a serious illness and mortality rates remain high, ranging between 20% and 40%. Previous reports have evidenced the potential role of cytokines in the diagnosis of this disease, but no information is available on their relationship with outcome. We recruited 26 consecutive patients with late prosthetic valve endocarditis requiring surgical treatment according to Duke criteria. Eight cytokines were measured in plasma in the first 24 h following diagnosis by using a Bio-Rad multiplex assay. Levels of IL-6, IL-8 and interferon gamma (IFN-γ) were higher in non survivors. Receiver operating characteristic curve analysis evidenced that IL-6, IL-8 and IFN-γ behaved as good diagnostic tests for identifying those patients with fatal outcome (area under the curve, CI 95%, p): IL-6: [0.81 (0.61-1.00) 0.012]; IL-8 [0.76 (0.56-0.96) 0.035]; IFN-γ [0.79 (0.59-0.99) 0.021]. Levels of IL-6, IL-8 and IFN-γ correlated positively between them, indicating that they are produced as consequence of a simultaneous response to the infection. Our findings support the participation of IL-6, IL-8 and IFN-γ in the events linked to fatal outcome in infective prosthetic valve endocarditis.

Inflammatory biomarkers in infective endocarditis: machine learning to predict mortality

“…In previous studies, IL-6, CXCL8 and IFN-γ were described as possible biomarkers for predicting mortality [26,27]. In previous studies, IL-6, CXCL8 and IFN-γ were described as possible biomarkers for predicting mortality [26,27].…”

“…First, both IL-15 and CCL4 were not included in the analysis of previously mentioned studies [25,26]. Variables are expressed as median (interquartile range).…”

“…Existing literature concerning the relationship between cytokines, growth factors and colony-stimulating factors and death in IE is scarce. In previous studies, IL-6, CXCL8 and IFN-γ were described as possible biomarkers for predicting mortality [26,27].…”

“…Even when IE is compared to other non-IE infections, the cytokine profile is different [24,25,27,28], which suggests a specific cytokine profile in the IE setting. Subsequently, when comparing the cytokine levels of IE patients with the clinical outcome, higher levels of cytokines were found in IE patients who died [26,27]. However, one of these studies included only 26 subjects: late prosthetic IE patients who had already required surgery, thus representing a specific IE population.…”

“…Previous studies have demonstrated that cytokine patterns of IE patients differ from those of healthy individuals [20][21][22][23][24][25][26][27][28]. Even when IE is compared to other non-IE infections, the cytokine profile is different [24,25,27,28], which suggests a specific cytokine profile in the IE setting.…”