title: High levels of interleukin-8 in the blood and alveolar spaces of patients with pneumonia and adult respiratory distress syndrome.
abstract: There is ample experimental evidence that polymorphonuclear neutrophils (PMN) play a critical role in the pathogenesis of the adult respiratory distress syndrome (ARDS). Since interleukin-8 (IL-8) is a strong chemotactic factor for PMN, we measured IL-8 levels in plasma and bronchoalveolar lavage (BAL) fluid of 18 patients, 12 with ARDS and 6 with severe pneumonia uncomplicated by ARDS, all of whom had an increased number of PMN in BAL fluid. Seven healthy subjects served as controls. We found elevated levels of IL-8 in the alveolar spaces of all patients tested. Elevated BAL IL-8 levels were related to a fatal outcome and the presence of shock and correlated with a general clinical severity index (simplified acute physiological score). BAL fluid levels of IL-8 were significantly higher in patients with ARDS than in patients with pneumonia. In plasma, IL-8 levels were increased similarly in all patients and did not correlate with survival or the presence of shock. The BAL fluid-to-plasma ratio of IL-8 was significantly greater than that of tumor necrosis factor alpha, indicating higher local production of IL-8. Moreover, the presence of a primed subpopulation of blood PMN with respect to H2O2 production indicates that IL-8 may contribute to the neutrophil-mediated process in the pathogenesis of ARDS and pneumonia.
authors.affiliation: Laboratoire d'Immunologie et d'Hématologie, Faculté Xavier Bichat, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Chollet-Martin
authors.forename: P
authors.initials: P
authors.lastname: Montravers
authors.forename: C
authors.initials: C
authors.lastname: Gibert
authors.forename: C
authors.initials: C
authors.lastname: Elbim
authors.forename: J M
authors.initials: JM
authors.lastname: Desmonts
authors.forename: J Y
authors.initials: JY
authors.lastname: Fagon
authors.forename: M A
authors.initials: MA
authors.lastname: Gougerot-Pocidalo
mesh_terms: D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D006801:Humans; D006861:Hydrogen Peroxide / Q000378:metabolism; D016209:Interleukin-8 / Q000032:analysis* / Q000097:blood / Q000502:physiology; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D011014:Pneumonia / Q000378:metabolism*; D012128:Respiratory Distress Syndrome / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000502:physiology
chemical_list: D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D006861:Hydrogen Peroxide