Time course of cytokine levels in sepsis.
In severe sepsis, a network of proinflammatory cytokines (TNF, IL-1 beta, IL-6, IL-8) is activated and blood levels of these cytokines are elevated, albeit inconsistently and with large individual variations. In addition, elevated blood levels of anti-inflammatory cytokines (IL-10), as well as of soluble cytokine receptors (sTNF-RI and II, IL-1ra), have been found. They seem to have a regulatory function in the host response. Levels of TNF and IL-6 are usually highest at the time of admission, whereas the time course of IL-1 beta levels (when detectable) can vary considerably. Limited data on IL-8 levels suggest that they may remain elevated for longer periods. Elevated levels of sTNFR and IL-1ra may also persist for a prolonged period of time. The pathogenetic significance of these observations is still unclear, but persistingly high levels of proinflammatory cytokines may be associated with organ failure and mortality.
Thijs
L G
LG
Medical Intensive Care Unit, Free University Hospital, Amsterdam, The Netherlands.
Hack
C E
CE
D006801:Humans; D007378:Interleukins / Q000097:blood / Q000276:immunology*; D009102:Multiple Organ Failure / Q000276:immunology; D011379:Prognosis; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000401:mortality; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000276:immunology*
D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha