title: Serum TNF-related and weak inducer of apoptosis levels in septic shock patients.
abstract: Capillary permeability is a tightly regulated feature of microcirculation in all organ beds. In sepsis, this feature is fundamentally altered. We have previously reported elevated levels of angiopoietin-2 in patients with septic shock, and have investigated tumor necrosis factor (TNF)-related and weak inducer of apoptosis (TWEAK), which mediates both angiogenesis and inflammation, in those patients. Enzyme-linked immunoassay was used to measure serum TWEAK levels in 20 patients with septic shock, all of whom were treated by direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX), and in 20 non-septic controls. The TWEAK levels were higher in patients with septic shock (192.8 ± 230.5 pg/mL) than in controls (84.1 ± 28.7 pg/mL, P = 0.043). Between 11 survivors and 10 non-survivors, there was no significant difference in the serum TWEAK levels before the DHP-PMX therapy. During DHP-PMX therapy, however, the serum TWEAK levels were significantly increased in non-survivors (142.2 ± 88.1 pg/mL to 399.0 ± 307.1 pg/mL, P = 0.022). There was a significant correlation between the serum TWEAK levels and white blood cell counts (r = 0.393, P < 0.001), platelet counts (r = 0.418, P < 0.001), or serum CRP levels (r = 0.259, P = 0.029), but there was no correlation between the serum TWEAK levels and blood pressure. The serum TWEAK levels were also correlated with the ratio of angiopoietin-2 to -1 (r = 0.464, P < 0.001). TWEAK may be a suitable marker of disease severity and mortality in septic patients, and TWEAK levels may be associated with vascular permeability via angiopoietin balance.
authors: Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, Ami, Japan. m-nagai@tokyo-med.ac.jp
authors: Miho
authors: M
authors: Nagai
authors: Kouichi
authors: K
authors: Hirayama
authors: Itaru
authors: I
authors: Ebihara
authors: Takashi
authors: T
authors: Higuchi
authors: Masahiro
authors: M
authors: Imaizumi
authors: Hiroshi
authors: H
authors: Maruyama
authors: Yasunori
authors: Y
authors: Miyamoto
authors: Tomoko
authors: T
authors: Kakita
authors: Yujiro
authors: Y
authors: Ogawa
authors: Shogo
authors: S
authors: Fujita
authors: Homare
authors: H
authors: Shimohata
authors: Masaki
authors: M
authors: Kobayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D042683:Angiopoietin-1 / Q000378:metabolism; D042702:Angiopoietin-2 / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002199:Capillary Permeability; D000074049:Cytokine TWEAK; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011112:Polymyxin B / Q000737:chemistry; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D017741:Survivors; D048069:Tumor Necrosis Factors / Q000097:blood*
chemical_list: D042683:Angiopoietin-1; D042702:Angiopoietin-2; D015415:Biomarkers; D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors; D002097:C-Reactive Protein; D011112:Polymyxin B