Association of proinflammatory molecules with apoptotic markers and survival in critically ill multiple organ dysfunction patients.
Recent evidence supports the involvement of apoptosis in multiple organ dysfunction (MODS). The authors examined the hypothesis that nitric oxide (NO), interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, and cortisol correlate with Fas and Fas ligand (FasL) expression on peripheral blood mononuclear cells and that Fas and FasL, therefore, mediate their association with MODS severity. Thirty-five critically ill adult MODS patients were followed for up to 14 days and were compared to non-MODS matched controls. Fas, FasL, nitrate, cortisol, and IL-6 were elevated in MODS patients (P < 0.05). Nitrate and cortisol correlated with Fas expression (P < 0.05). All factors studied, except for TNF-alpha, correlated with MODS severity (P < 0.05); however, by multivariate analyses, Fas and FasL were independently associated with severity and survival (P < 0.05). The inflammatory molecules studied may mediate the association of apoptotic constituents with MODS severity and survival only in part.
Papathanassoglou
Elizabeth D E
ED
University of Athens, School of Nursing, Papadiamantopoulou 123, Athens 11527, Greece. elipapa@nurs.uoa.gr
Movnihan
Jan A
JA
Dafni
Ourania
O
Mantzoros
Christos S
CS
Ackerman
Michael H
MH
D000328:Adult; D000368:Aged; D017209:Apoptosis / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016638:Critical Illness / Q000401:mortality; D003430:Cross-Sectional Studies; D053222:Fas Ligand Protein; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007249:Inflammation; D018836:Inflammation Mediators / Q000097:blood* / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood* / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000737:chemistry; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000276:immunology / Q000401:mortality; D015999:Multivariate Analysis; D009569:Nitric Oxide / Q000097:blood* / Q000276:immunology; D012720:Severity of Illness Index; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000276:immunology / Q000401:mortality; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology / Q000378:metabolism*; D015854:Up-Regulation; D019014:fas Receptor / Q000032:analysis
D015415:Biomarkers; C505661:FASLG protein, human; D053222:Fas Ligand Protein; D018836:Inflammation Mediators; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D014409:Tumor Necrosis Factor-alpha; D019014:fas Receptor; D009569:Nitric Oxide; D006854:Hydrocortisone