Prognostic Values of Tumor Necrosis Factor/Cachectin, Interleukin-l, Interferon- , and Interferon-  in the Serum of Patients with Septic Shock

Abstract

Serum concentrations of immunoreactive tumor necrosis factor/cachectin (TNF), interleukin-1 beta (IL-1 beta), interferon-gamma (IFN gamma), and interferon-alpha (IFN alpha) were prospectively measured in 70 patients with septic shock to determine their evolution and prognostic values. In a univariate analysis, levels of TNF (P = .002) and IL-1 beta (P = .05) were associated with the patient's outcome, but not IFN alpha (P = .15) and IFN gamma (P = .26). In contrast, in a stepwise logistic regression analysis, the severity of the underlying disease (P = .01), the age of the patient (P = .02), the documentation of infection (nonbacteremic infections vs. bacteremias, P = .03), the urine output (P = .04), and the arterial pH (P = .05) contributed more significantly to prediction of patient outcome than the serum levels of TNF (P = .07). After 10 days, the median concentration of TNF was undetectable (less than 100 pg/ml) in the survivors, whereas it remained elevated (305 pg/ml, P = .002) in the nonsurvivors. Thus, in patients with septic shock due to various gram-negative bacteria, other parameters than the absolute serum concentration of immunoreactive TNF contributed significantly to the prediction of outcome.

TNF-α impairs heart and skeletal muscle protein synthesis by altering translation initiation

“…We have previously reported that this experimental protocol elevates the blood TNF-␣ concentration to ϳ500 pg/ml (12). Comparable TNF-␣ values are observed in a number of inflammatory conditions, including sepsis, neoplastic disease, burn injury, and hepatic ischemia-reperfusion injury (6,7,9,11), but levels are markedly lower than those seen in rats injected with nonlethal doses of endotoxin (18). In addition, this dose of TNF-␣ also produces peripheral insulin resistance (29) and decreases the IGF-I content in blood and muscle (12).…”

Interleukin 12 Levels During the Initial Phase of Septic Shock With Purpura in Children: Relation to Severity of Disease

“…However, it is not known whether IFN-g similarly contributes to mortality in human sepsis. IFN-g levels and outcome were not correlated in adult patients with septic shock 22 and in children with meningococcal septic shock. 1 In contrast, Girardin et al reported high levels of IFN-g in children with severe meningococcal septic shock.…”

“…8 IL-12 also induces the production of interferon (IFN)-g by T cells and natural killer (NK)-cells. 16, 17 The plasma levels of IFN-g are increased in experimental models for sepsis [18][19][20] as well as in human sepsis, 21,22 although not consistently. 1 Recently, IL-12 was characterized as a major cytokine in the pathogenesis of gram-negative endotoxaemia in mice 16 and in primates.…”

Park7 interacts with p47phox to direct NADPH oxidase-dependent ROS production and protect against sepsis

“…As IL-6 and TNF-α are proinflammatory cytokines elevated during the early septic hyperinflammation and are negatively correlated with the septic survival [17,18], their concentrations in serum and peritoneal fluid were measured by ELISA. 24 h after CLP or LPS, levels of IL-6 and TNF-α in serum or peritoneal fluid were significantly lower in Park7 −/− mice compared with WT mice (Figure 2A-2D).…”