Prognostic value of MIP-1 alpha, TGF-beta 2, sELAM-1, and sVCAM-1 in patients with gram-positive sepsis.
The aim of the present study was to evaluate the potential prognostic value of MIP-1 alpha, TGF-beta 2, sELAM-1, and sVCAM-1 in patients with gram-positive sepsis. Twenty-eight patients with gram-positive sepsis were compared to 11 patients with gram-negative sepsis and 15 healthy volunteers. Sepsis was defined by the criteria of Bone et al. (Crit. Care Med. 21, 5447-5463, 1993) and by isolation of at least two positive blood cultures with gram-positive/gram-negative bacteria. Plasma samples for determination of the immunological parameters were collected daily. Analysis of cytokines and adhesion molecules was performed on days 0 (day of sepsis criteria fulfillment), 4, and 7 (or 1 day before death). In the gram-positive group 10 of 28 patients died; in the gram-negative group 4 of 11 died. Only sELAM-1 plasma concentrations were found to be a useful early parameter in predicting patients' outcome in gram-positive sepsis. sELAM-1 concentrations at the onset of the study (day 0) were significantly higher in the nonsurviving patients than those in the survivors. MIP-1 alpha levels were significantly higher only on days 4 and 7. With regard to the measured plasma concentrations we believe that MIP-1 alpha is not a useful parameter for predicting patients' prognosis. The increase of sVCAM-1 might play a role in the pathogenesis of gram-positive sepsis; however, it could not be relied upon as an early prognostic parameter. The potential role of TGF-beta 2 in the development of gram-positive sepsis could not evaluated in the present study, whereas routine measurements of TGF-beta 2 offered no additional prognostic information.
Knapp
S
S
Department of Internal Medicine I, University of Vienna, Austria.
Thalhammer
F
F
Locker
G J
GJ
Laczika
K
K
Hollenstein
U
U
Frass
M
M
Winkler
S
S
Stoiser
B
B
Wilfing
A
A
Burgmann
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054407:Chemokine CCL4; D019040:E-Selectin / Q000097:blood*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000097:blood*; D006801:Humans; D019402:Macrophage Inflammatory Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood*; D016212:Transforming Growth Factor beta / Q000097:blood*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D054407:Chemokine CCL4; D019040:E-Selectin; D019402:Macrophage Inflammatory Proteins; D016212:Transforming Growth Factor beta; D019010:Vascular Cell Adhesion Molecule-1