Imbalance between macrophage migration inhibitory factor and cortisol induces multiple organ dysfunction in patients with blunt trauma.
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.
Hayakawa
Mineji
M
Emergency and Critical Care Center, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8648, Japan. mineji@dream.com
Katabami
Kenichi
K
Wada
Takeshi
T
Minami
Yousuke
Y
Sugano
Masahiro
M
Shimojima
Hidekazu
H
Kubota
Nobuhiko
N
Uegaki
Shinji
S
Sawamura
Atsushi
A
Gando
Satoshi
S
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
D018836:Inflammation Mediators; D008263:Macrophage Migration-Inhibitory Factors; D014409:Tumor Necrosis Factor-alpha; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human; D006854:Hydrocortisone