title: Cytokines and chemokines in serum and urine as early predictors to identify septic patients on intensive care unit.
abstract: The aim of this prospective cohort study was to address the feasibility of measuring cytokines in serum and urine as early predictor tests for the identification of septic Intensive Care Unit (ICU) patients. The study group consisted of 10 septic and 5 non-septic patients at the onset of sepsis according to modified definitions by the American College of Chest Physicians (ACCP)/Society of Critical Care Medicine (SCCM). Serum and urine samples were taken from septic patients at the onset of sepsis and from non-septic patients, every 12 h for 3 days and thereafter every 24 h until day 10. Levels of TNF-alpha, IL-1beta, IL-6, IL-10, IL-18, IFN-gamma, MCP-1, and PCT (procalcitonin) were measured by ELISA. Apart from serum IL-18 and PCT levels, which were elevated in septic patients (p<0.05), levels of all other cytokines and chemokines in the serum of septic patients did not exceed those of the control group. In urine, in contrast with TNF-alpha, IL-1beta, IL-6, IL-10, IFN-gamma, and MCP-1 in which no differences between the two groups were observed, a distinct trend of elevated IL-18 levels was observed only in the septic group. Whereas elevated serum IL-18 and PCT are clear candidate markers for sepsis criteria, the present data indicating elevated urine IL-18 levels albeit from a limited number of septic patients is an interesting observation. The profile of inflammatory mediators in serum and urine from septic patients herein warrants further investigations in a larger group of patients at the onset of sepsis driven by different infectious foci.
authors.affiliation: Department of Trauma Surgery, University Hospital of Bonn Medical School, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
authors.forename: Koroush
authors.initials: K
authors.lastname: Kabir
authors.forename: Hendrik
authors.initials: H
authors.lastname: Keller
authors.forename: Guido
authors.initials: G
authors.lastname: Grass
authors.forename: Thomas
authors.initials: T
authors.lastname: Minor
authors.forename: Frank
authors.initials: F
authors.lastname: Stueber
authors.forename: Stefan
authors.initials: S
authors.lastname: Schroeder
authors.forename: Christian
authors.initials: C
authors.lastname: Putensen
authors.forename: Christian
authors.initials: C
authors.lastname: Paul
authors.forename: Christoph
authors.initials: C
authors.lastname: Burger
authors.forename: Christoph
authors.initials: C
authors.lastname: Rangger
authors.forename: Lewis F
authors.initials: LF
authors.lastname: Neville
authors.forename: Guenther
authors.initials: G
authors.lastname: Mathiak
mesh_terms: D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood / Q000652:urine; D015740:Calcitonin Gene-Related Peptide; D018925:Chemokines / Q000097:blood* / Q000652:urine*; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood* / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D020382:Interleukin-18 / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood / Q000652:urine; D012333:RNA, Messenger / Q000378:metabolism; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D013997:Time Factors
chemical_list: C000606589:CALCA protein, human; D018925:Chemokines; D016207:Cytokines; D020382:Interleukin-18; D011498:Protein Precursors; D012333:RNA, Messenger; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide