title: Reciprocal changes in circulating interleukin-6 and its soluble receptor during evolving sepsis in leukocytopenic patients.
abstract: Plasma concentrations of interleukin-6 (IL-6) and its soluble receptor (sIL-6R) were serially determined in 32 patients with acute myeloid leukemia who developed severe sepsis (n = 19) or septic shock (n = 13) during chemotherapy-induced leukocytopenia (< or = 1 x 10(9)/L). Starting within 2 h of fever onset, IL-6 levels rose significantly over baseline in both groups to markedly higher levels in patients with evolving septic shock (medians: 372 vs. 3671 pg/mL; P < .001). Simultaneously, sIL-6R significantly decreased to lower levels in shock patients than in septic patients without hypotension (53 vs. 93 ng/mL; P = .02). This pattern was maintained throughout the observation period of up to 6 days. In patients with fatal sepsis, peak IL-6 levels were significantly higher than in survivors (P < .001), whereas minimum sIL-6R levels were markedly lower (P = .003). The reciprocal changes in circulating IL-6 and sIL-6R suggest a role for sIL-6R in modulating the effects of IL-6 during evolving sepsis in leukocytopenic patients.
authors.affiliation: Department of Internal Medicine, University of Muenster, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Ostermann
authors.forename: K
authors.initials: K
authors.lastname: Kratz-Albers
authors.forename: R M
authors.initials: RM
authors.lastname: Mesters
authors.forename: M
authors.initials: M
authors.lastname: Kiehl
authors.forename: J
authors.initials: J
authors.lastname: Kienast
mesh_terms: D000208:Acute Disease; D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007951:Leukemia, Myeloid / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D007970:Leukopenia / Q000097:blood* / Q000139:chemically induced / Q000150:complications; D008297:Male; D008875:Middle Aged; D018123:Receptors, Interleukin / Q000097:blood*; D019947:Receptors, Interleukin-6; D018805:Sepsis / Q000097:blood* / Q000150:complications; D012995:Solubility
chemical_list: D015703:Antigens, CD; D015850:Interleukin-6; D018123:Receptors, Interleukin; D019947:Receptors, Interleukin-6