title: Macrophage migration inhibitory factor levels correlate with fatal outcome in sepsis.
abstract: Macrophage migration inhibitory factor (MIF) is a cytokine playing a critical role in the pathophysiology of experimental sepsis. The purpose of this study was to determine the levels of MIF and to compare those to interleukin-6 (IL-6) levels in predicting mortality among critically ill patients with sepsis. The levels of MIF and IL-6 were measured in 25 patients with septic shock, 17 patients with sepsis, and 11 healthy volunteers. The median plasma concentrations of MIF and IL-6 were significantly higher in patients with septic shock and in patients with sepsis than in healthy controls. MIF levels were significantly different between survivors and nonsurvivors, as were IL-6 levels. Discriminatory power in predicting mortality, as assessed by the areas under receiver operating characteristic curves (AUROC), was 0.793 for MIF and 0.680 for IL-6. Finally, high plasma levels of MIF (> 1100 pg/mL) had a sensitivity of 100% and a specificity of 64% to identify the patients who eventually would evolve to a fatal outcome. Thus, our data suggest that an elevated MIF level in recently diagnosed septic patients appears to be an early indicator of poor outcome and a potential entry criterion for future studies with therapeutic intervention aiming at MIF neutralization.
authors.affiliation: ICU, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Bozza
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Gomes
authors.forename: André M
authors.initials: AM
authors.lastname: Japiassú
authors.forename: Marcio
authors.initials: M
authors.lastname: Soares
authors.forename: Hugo C
authors.initials: HC
authors.lastname: Castro-Faria-Neto
authors.forename: Patrìcia T
authors.initials: PT
authors.lastname: Bozza
authors.forename: Marcelo T
authors.initials: MT
authors.lastname: Bozza
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood*; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000276:immunology* / Q000401:mortality*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D008263:Macrophage Migration-Inhibitory Factors