The prognostic value of serum cytokine levels in patients with acute infections.
BACKGROUND
Elevation of serum cytokine level, especially tumor necrosis factor-alpha (TNF-alpha) and granulocyte-colony stimulating factor (G-CSF), has been reported in acute bacterial infection. Elevation of serum TNF-alpha level upon patients' admission has also been reported to correlate with the fatal outcome.


METHODS
The present study is to evaluate, in addition to TNF-alpha and G-CSF, whether serum stem cell factor (SCF), interleukin-3 (IL-3) and granulocyte-macrophage-CSF (GM-CSF) levels to see if they were also elevated in patients with acute bacterial infection. It also tries to evaluate whether different degree of elevation of cytokine levels had any relationship to patients' clinical parameter, including fatality. Correlation between different kinds of cytokines was also studied.


RESULTS
Patients with bacterial growth in blood culture had higher level of serum G-CSF. Higher level of serum TNF-alpha was significantly associated with the occurrence of septic shock, but not of fatal outcome. Low serum G-CSF and high serum SCF level were significantly associated with fatal outcome; however, all the patients still had serum SCF levels within normal range. GM-CSF and IL-3 play no obvious role as systemic effector molecule in acute bacterial infection.


CONCLUSIONS
Higher levels of serum TNF-alpha are associated with the occurrence of septic shock. Low serum G-CSF levels are significantly associated with fatal outcome. Routine monitoring of serum G-CSF level in patients with severe infection in order to supplement recombinant G-CSF can possibly help patients to overcome the disaster.
Chen
Y M
YM
Cancer Clinical Research Center, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, R.O.C.
Whang-Peng
J
J
Chern
C H
CH
Kuo
B I
BI
Wang
S Y
SY
Perng
R P
RP
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000097:blood*; D016207:Cytokines / Q000097:blood*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019089:Stem Cell Factor / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D019089:Stem Cell Factor; D014409:Tumor Necrosis Factor-alpha; D016179:Granulocyte Colony-Stimulating Factor