Tumor necrosis factor alpha (TNF-alpha) and sepsis: evidence for a role in host defense.
Serum levels of TNF-alpha were evaluated in 29 patients with sepsis, using TNF-alpha sensitive L929 cells (sensitivity = 15 pg/ml). Blood samples were collected serially at the first 24-36 h of symptoms. Seventeen patients had severe underlying disease and 12 patients had mild or no underlying disease. Shock was present in 25 patients. Overall mortality was 62.1%. TNF-alpha was detected in nine patients (range: 57.7-3,169 pg/ml). There was a tendency to detect TNF-alpha in patients with mild or no underlying disease (p = 0.07). Detection of TNF-alpha was associated with survival (p = 0.0003) even when adjusted for severity of underlying disease (p = 0.005), shock (p = 0.0005), coagulation abnormality (p = 0.002) and immunosuppressive therapy (p = 0.005), using a bivariate analysis. In this investigation, detection of circulating TNF-alpha was predictive of good outcome in septic patients, suggesting a role for this cytokine in host-defense against this kind of infection.
Rigato
O
O
Dept. of Infectious Diseases, Universidade Federal de São, Paulo, Escola Paulista de Midicina, Brazil.
Ujvari
S
S
Castelo
A
A
Salomão
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D005260:Female; D006801:Humans; D007739:L Cells; D008297:Male; D051379:Mice; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018805:Sepsis / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D014409:Tumor Necrosis Factor-alpha