Dissociation of LPS-induced monocytic ex vivo production of granulocyte colony-stimulating factor (G-CSF) and TNF-alpha in patients with septic shock.
Over a 6 month period, in 192 patients admitted to the intensive care unit (ICU), a longitudinal analysis of whole blood lipopolysaccharide (LPS)-induced ex vivo cytokine production was performed on a daily basis until discharge from the ICU or death. Twenty-one patients with proven infections were in septic shock for the first time and for at least 3 days' duration. Ex vivo LPS-inducible release of granulocyte colony-stimulating factor (G-CSF) was upregulated and that of TNF-alpha was downregulated in patients with septic shock, regardless whether they survived or died. In conclusion, LPS-induced ex vivo TNF-alpha and G-CSF cytokine release by monocytes is regulated differentially in patients with septic shock. Since upregulation of LPS-induced production of G-CSF occurred earlier in survivors than in non-survivors, rapidly elevated and sustained G-CSF responsiveness may contribute to survival in septic shock.
Weiss
M
M
Department of Anaesthesiology, Universitaetsklinikum, Steinhoevelstr. 9, Ulm, 89075, Germany. manfred.weiss@medizin.uni-ulm.de
Fischer
G
G
Barth
E
E
Boneberg
E
E
Schneider
E M
EM
Georgieff
M
M
Hartung
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D015536:Down-Regulation / Q000187:drug effects; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D066298:In Vitro Techniques; D008070:Lipopolysaccharides / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects* / Q000378:metabolism*; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D015854:Up-Regulation / Q000187:drug effects
D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D016179:Granulocyte Colony-Stimulating Factor