title: Relationships between plasma cytokine concentrations and leukocyte functional antigen expression in patients with sepsis.
abstract: OBJECTIVE
  To determine the relationships between cytokine concentrations and alterations in leukocyte functional antigen expression in sepsis.
  
  
  METHODS
  Prospective, cross-sectional study.
  
  
  METHODS
  Respiratory, coronary, and medical intensive care units in a university hospital.
  
  
  METHODS
  Forty subjects consisting of: a) patients with severe sepsis, b) patients with sepsis, c) critically ill nonseptic patients, and d) normal controls.
  
  
  METHODS
  None.
  
  
  METHODS
  Plasma concentrations of interleukin (IL)-1 beta, IL-6, IL-8, IL-10, interleukin-1 receptor antagonist (IL-1Ra), and tumor necrosis factor (TNF)-alpha were determined by enzyme-linked immunosorbent assay (ELISA). Peripheral blood monocyte HLA-DR and CD14 expression and neutrophil CD11b expression were determined by flow cytometry. Measurements were taken within 24 hrs of admission to the intensive care unit and/or clinical presentation.
  
  
  RESULTS
  Significantly increased plasma IL-6, IL-8, IL-10, and TNF-alpha concentrations were observed in the severe sepsis group compared to normal controls. Increases in IL-1Ra were not significant. Monocyte HLA-DR expression, significantly decreased in patients with severe sepsis, was correlated both with IL-6 (p < .005) and IL-8 concentrations (p < .001). Both of these cytokines had close correlations to Acute Physiology and Chronic Health Evaluation (APACHE) II scores which were also correlated with monocyte HLA-DR. Neutrophil CD11b, which was increased in all infected patients, was significantly correlated with the ratio between IL-1 and IL-1Ra concentrations (p < .001). The percent of CD14+ monocytes was lowest in patients with severe sepsis and showed a significant covariate effect from IL-8 concentrations (p < .001).
  
  
  CONCLUSIONS
  These findings suggest that the expression of specific functional molecules on peripheral blood leukocytes is variably related to the net production of certain monokines in sepsis.
authors.affiliation: Department of Medicine, St. Vincent's Hospital and Medical Center of New York-New York Medical College 10011.
authors.forename: R Y
authors.initials: RY
authors.lastname: Lin
authors.forename: M E
authors.initials: ME
authors.lastname: Astiz
authors.forename: J C
authors.initials: JC
authors.lastname: Saxon
authors.forename: D C
authors.initials: DC
authors.lastname: Saha
authors.forename: E C
authors.initials: EC
authors.lastname: Rackow
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003422:Critical Care; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D016130:Immunophenotyping; D016169:Lymphocyte Function-Associated Antigen-1 / Q000096:biosynthesis / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000276:immunology*
chemical_list: D016207:Cytokines; D016169:Lymphocyte Function-Associated Antigen-1