Serum MIP-1 alpha and IL-8 in septic patients.
We studied blood MIP-1 alpha and IL-8 in 38 septic patients and 5 healthy volunteers. Both chemokines were undetectable in the healthy volunteers. In sepsis, serum MIP-1 alpha was detected in 45% of the patients and Il-8 in 84%. The levels of MIP-1 alpha, but not of IL-8, correlated with CRP, IL-6 and TNF alpha levels. Complications, including various organ failures and mortality, showed no correlation with serum MIP-1 alpha levels. In contrast, we found increased levels of serum IL-8 in septic patients with disseminated intravascular coagulation, central nervous system (CNS) dysfunction or renal failure, and the mortality rate was higher in the IL-8 detectable group than in the IL-8 undetectable group (50% vs 0%, p < 0.05). In conclusion, the production of both MIP-1 alpha and IL-8 was increased and initially detectable levels of circulating IL-8 predicted high mortality in sepsis.


OBJECTIVE
To determine the significance of the C-C chemokine MIP-1 alpha and the C-X-C chemokine IL-8 in sepsis.


METHODS
Prospective study.


METHODS
Clinical investigation, emergency department and general intensive care unit of university hospital.


METHODS
38 septic patients and 5 healthy volunteers were studied. Sepsis was diagnosed following the criteria formulated by ACCP/SCCM.


METHODS
10-20 ml of blood was drawn from each patient at the time of initial diagnosis of sepsis.


RESULTS
MIP-1 alpha and IL-8 were determined by sandwich ELISA. Both chemokines were undetectable in the healthy volunteers. In sepsis, serum MIP-1 alpha was detected in 45% of the patients and IL-8 was detected in 84%. The levels of MIP-1 alpha, but not of IL-8, correlated with CRP, IL-6 and TNF alpha levels. Complications, including various organ failures and mortality, showed no correlation with serum MIP-1 alpha levels. In contrast, we found increased levels of serum IL-8 in patients with disseminated intravascular coagulation (DIC) (p < 0.05), central nervous system (CNS) dysfunction (p < 0.05), renal failure (p < 0.01) and the mortality rates were higher in the IL-8 detectable group than in the IL-8 undetectable group (50% vs 0%, p < 0.05).


CONCLUSIONS
The production of MIP-1 alpha and IL-8 was increased in sepsis. Furthermore, an initially detectable level of circulating IL-8, but not MIP-1 alpha, predicted a high mortality in sepsis diagnosed according to the ACCP/SCCM criteria.
Fujishima
S
S
Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan.
Sasaki
J
J
Shinozawa
Y
Y
Takuma
K
K
Kimura
H
H
Suzuki
M
M
Kanazawa
M
M
Hori
S
S
Aikawa
N
N
D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D054407:Chemokine CCL4; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000401:mortality; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000097:blood* / Q000276:immunology; D007564:Japan / Q000453:epidemiology; D019402:Macrophage Inflammatory Proteins / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D018709:Statistics, Nonparametric
D015415:Biomarkers; D054407:Chemokine CCL4; D016209:Interleukin-8; D019402:Macrophage Inflammatory Proteins