title: Imbalance between macrophage migration inhibitory factor and cortisol induces multiple organ dysfunction in patients with blunt trauma.
abstract: Migration inhibitory factor (MIF) is associated with multiple organ dysfunction syndrome (MODS) in patients with systemic inflammatory response syndrome (SIRS). Our purposes were to determine the serum MIF, cortisol, and tumor narcosis factor-α (TNF-α) and to investigate the influences of the balance between the levels of MIF and cortisol in patients with blunt trauma. The cortisol levels were identical between the patients with and without MODS. However, the MIF and TNF-α levels in the patients with MODS were statistically higher than those of the patients without MODS. The cortisol/MIF ratios in the patients with MODS were statistically higher than those of the patients without MODS. The results show that MIF and TNF-α play an important role together in posttraumatic inflammatory response. An excessive serum MIF elevation overrides the anti-inflammatory effects of cortisol and leads to persistent SIRS followed by MODS in blunt trauma patients.
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8648, Japan. mineji@dream.com
authors.forename: Mineji
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Katabami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Minami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sugano
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Shimojima
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kubota
authors.forename: Shinji
authors.initials: S
authors.lastname: Uegaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sawamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Gando
mesh_terms: D000328:Adult; D005260:Female; D016489:Head Injuries, Closed / Q000097:blood / Q000150:complications; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood; D019746:Intramolecular Oxidoreductases / Q000097:blood*; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014949:Wounds, Nonpenetrating / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D018836:Inflammation Mediators; D008263:Macrophage Migration-Inhibitory Factors; D014409:Tumor Necrosis Factor-alpha; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human; D006854:Hydrocortisone