Interleukin-6 and its soluble receptor during acute meningococcal infections: effect of plasma or whole blood exchange.
OBJECTIVE
To determine the pattern of the soluble interleukin (IL)-6 receptor during acute meningococcal infections and recovery phase, and to measure the effect of plasma or whole blood exchange on the plasma concentrations of these mediators.


METHODS
Prospective, descriptive patient study.


METHODS
University hospital intensive care unit.


METHODS
Patients with bacteriologically proven meningococcal infections were entered in the study. Three group were formed: a) patients with meningitis without shock (group A); b) patients with meningitis and shock (group B); and c) patients with shock only (group C).


METHODS
Part (n = 9) of the patients with shock underwent plasma or whole blood exchange.


RESULTS
Serum concentrations of interleukin-6 and soluble IL-6 receptors were determined sequentially during the acute and recovery phases. Peak concentrations of IL-6 were highest in group C, followed by group B and group A. Soluble IL-6 receptor concentrations showed an opposite pattern and were all below normal. Soluble IL-6 receptor concentrations were negatively correlated with the IL-6 concentrations. During recovery, IL-6 rapidly decreased and soluble IL-6 receptors increased to supranormal concentrations, after which concentrations returned to normal. Plasma or whole blood exchange did not significantly influence IL-6 concentrations but did increase the soluble IL-6 receptor concentration directly after an exchange session followed by a rapid decrease.


CONCLUSIONS
Soluble IL-6 receptor concentrations are low in acute meningococcal infections. Plasma or whole blood exchange temporarily increases these concentrations. It needs to be determined whether the effect of this therapy is beneficial to the patient.
Department of Surgery, University Hospital Nijmegen, The Netherlands.
J T
JT
Frieling
M
M
van Deuren
J
J
Wijdenes
R
R
van Dalen
A K
AK
Bartelink
C J
CJ
van der Linden
R W
RW
Sauerwein
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008589:Meningococcal Infections / Q000097:blood* / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D010951:Plasma Exchange; D011446:Prospective Studies; D018123:Receptors, Interleukin / Q000097:blood*; D019947:Receptors, Interleukin-6; D012769:Shock / Q000097:blood* / Q000150:complications* / Q000628:therapy
D015703:Antigens, CD; D015850:Interleukin-6; D018123:Receptors, Interleukin; D019947:Receptors, Interleukin-6