title: The importance of fever as a predictive symptom for the potency of host's monocytes to release pro- and anti-inflammatory mediators.
abstract: OBJECTIVE
  To clarify whether time lapsing from advent of fever as a first sign of sepsis may be indicative of the potency of monocytes for the release of pro- and anti-inflammatory mediators.
  
  
  METHODS
  Monocytes were isolated from blood of 51 septic patients and 9 healthy donors. Monocytes were incubated in the absence and presence of patients' serum and concentrations of tumour necrosis factor-alpha (TNF alpha), interleukin (IL)-6, IL-10, and malondialdehyde (MDA) were estimated in supernatants. Patients were divided into three groups: group A: <12 hours; group B: 12-24 hours, and group C: >24 hours between initiation of fever and blood sampling.
  
  
  RESULTS
  TNF alpha of supernatants of groups B and C was higher than controls, as also were IL-6 of A and C, IL-10 of A and B, and MDA of A. IL-6 of group A was increased after addition of patients serum. A negative correlation was found between time from initiation of symptoms and IL-6 of monocyte supernatants incubated in the presence of patients serum. Median IL-6 of survivors was higher than nonsurvivors.
  
  
  CONCLUSIONS
  Monocytes are potent for the release of pro- and anti-inflammatory mediators within the first 24 hours upon advent of fever related to sepsis; serum stimulates further release of IL-6 within the first 12 hours.
authors.affiliation: 4th Department of Internal Medicine, University of Athens Medical School, Attikon University Hospital, Athens 124 62, Greece.
authors.forename: Magdalini
authors.initials: M
authors.lastname: Kyriakopoulou
authors.forename: Anastasia
authors.initials: A
authors.lastname: Antonopoulou
authors.forename: Maria
authors.initials: M
authors.lastname: Raftogiannis
authors.forename: Fotini
authors.initials: F
authors.lastname: Baziaka
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsaganos
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Kanellakopoulou
authors.forename: Evangelos J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
mesh_terms: D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005334:Fever / Q000097:blood / Q000209:etiology / Q000276:immunology*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology / Q000276:immunology* / Q000378:metabolism*; D018805:Sepsis / Q000150:complications / Q000276:immunology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D008315:Malondialdehyde