Elevation in interleukin 13 levels in patients diagnosed with systemic inflammatory response syndrome.
OBJECTIVE
To examine plasma levels and circadian rhythm of interleukin 13 (IL-13), tumour necrosis factor (TNF) alpha and total serum cortisol in the systemic inflammatory response syndrome (SIRS).


METHODS
Prospective observational study in a 12-bed medical-surgical ICU of a 500-bed university hospital.


METHODS
Ten patients with SIRS and eight controls.


METHODS
Arterial blood was sampled hourly for 24 h for measurement of plasma IL-13, TNF- alpha, cortisol and white blood cell count (WCC) differential within 24 h of development of SIRS.


RESULTS
There were significantly higher plasma IL-13 levels in SIRS patients than in controls (1282 vs. 713 pg/ml). IL-13 was significantly higher in patients with a diagnosis of sepsis than in those with non-infectious causes of SIRS (2080 vs. 515 pg/ml). In SIRS the elevation in IL-13 was associated with higher TNF-alpha and reduced WCC. A circadian rhythm was observed in plasma IL-13 secretion. No distinct circadian rhythm was noted for TNF- alpha, and the normal circadian rhythm of serum cortisol was lost.


CONCLUSIONS
The anti-inflammatory cytokine IL-13 is elevated in early SIRS. Its plasma level exhibits a circadian rhythm and may be modulated in part by TNF-alpha. SIRS patients have disruption of the normal circadian rhythm of serum cortisol.
Socha
Luis A
LA
John Curtin School of Medical Research, Australian National University, ACT 2601, Canberra, Australia.
Gowardman
John
J
Intensive Care Unit, Launceston General Hospital, TAS 7250, Launceston, Australia. john.gowardman@dhhs.tas.gov.au.|Intensive Care Unit, Canberra Hospital, ACT 2605, Canberra, Australia. john.gowardman@dhhs.tas.gov.au.
Silva
Diego
D
John Curtin School of Medical Research, Australian National University, ACT 2601, Canberra, Australia.
Correcha
Manuel
M
John Curtin School of Medical Research, Australian National University, ACT 2601, Canberra, Australia.
Petrosky
Nikolai
N
Department of Endocrinology, Flinders Medical Centre, SA 5042, Adelaide, Australia.
D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D018793:Interleukin-13 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D018793:Interleukin-13; D014409:Tumor Necrosis Factor-alpha; D006854:Hydrocortisone