Longitudinal course and clinical significance of TGF-beta1, sL- and sE-Selectins and sICAM-1 levels during severe acute stress in children.
OBJECTIVE
To elucidate the potential role of circulating levels of transforming growth factor-beta1 (TGF-beta1), soluble intercellular adhesion molecule-1 (sICAM-1), soluble L- and sE-Selectins (sL- and sE-Selectins) in children with sepsis, traumatic brain injury (TBI) or acute respiratory distress syndrome (ARDS).


METHODS
Levels of TGF-beta1, sICAM-1, L- and sE-Selectins were determined using solid-phase sandwich enzyme-linked immunosorbent assay in plasma of 10 patients with sepsis, 10 patients with TBI, 10 patients with ARDS, compared to 10 ventilated controls with chronic illness but not in acute stress, on days 1, 3, 5, 7 and 10.


RESULTS
The highest values of sICAM-1 were observed in patients with TBI (p<0.001) and those of sE-Selectin in patients with sepsis (p=0.0001). Patients in the control group did not show an elevation of sE-Selectin and sICAM-1 levels longitudinally. Increased levels of measured molecules (TGF-beta1, p<0.02, sE-Selectin, p<0.02, sL-Selectin, p=0.06, sICAM-1, p<0.03) were demonstrated among survivors in the sepsis and ARDS groups of patients and were positively correlated with length of stay (p<0.04) and mechanical ventilation (p<0.001).


CONCLUSIONS
A sustained increase of adhesion molecules occurs during acute stress in children which may contribute to morbidity in patients with sepsis (sE-Selectin) or traumatic brain injury (sICAM-1). Suppression of the expected response of sE-Selectins, s-ICAM-1 and TGF-beta1 is associated with poor outcome.
Briassoulis
George
G
Paediatric Intensive Care Unit, University Hospital of Heraklion, Crete, Greece.
Papassotiriou
Ioannis
I
Mavrikiou
Maria
M
Lazaropoulou
Christina
C
Margeli
Alexandra
A
D000293:Adolescent; D001930:Brain Injuries / Q000097:blood / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D019040:E-Selectin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D019041:L-Selectin / Q000097:blood*; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000473:pathology; D018805:Sepsis / Q000097:blood / Q000473:pathology; D016019:Survival Analysis; D013997:Time Factors; D053773:Transforming Growth Factor beta1 / Q000097:blood*
D019040:E-Selectin; D053773:Transforming Growth Factor beta1; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin