title: Biochemical and inflammatory aspects in patients with severe sepsis and septic shock: The predictive role of IL-18 in mortality.
abstract: BACKGROUND
  Sepsis is a major health care problem, with a significant mortality rate in intensive care units. We evaluated biochemical and inflammatory markers in patients with severe sepsis and septic shock and its association of with mortality rates.
  
  
  METHODS
  Critically ill patients with diagnoses of sepsis - severe sepsis group (n=23) and septic shock group (n=25), and a control group (n=17) were recruited within 24h of entry into the ICU. Serum levels of inflammatory mediators were measured (IL-1β, IL-6, IL-8, IL-10, TNF-α, IL-18 and nitric oxide). We have also collected clinical parameters and laboratorial tests to estimate severity and organ dysfunction (APACHE II, SOFA, lactate). These results were compared between survivors and no survivors.
  
  
  RESULTS
  IL-18 was directly related to mortality independently of other inflammatory mediators, especially IL-1β, although the inflammatory pathway is closely linked to inflammasome activation and both have simultaneous release in the infectious process. Mortality was directly proportional to IL-18 plasma levels, which did not occur with other inflammatory mediators.
  
  
  CONCLUSIONS
  IL-18 is an important predictor of mortality in humans with both severe sepsis and septic shock, independent of IL-1β.
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Michelle V
authors.initials: MV
authors.lastname: Eidt
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil.
authors.forename: Fernanda Bordignon
authors.initials: FB
authors.lastname: Nunes
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pedrazza
authors.affiliation: Universidade de santa Cruz do Sul, UNISC, Santa Cruz do Sul, RS, Brazil.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Caeran
authors.affiliation: Universidade de santa Cruz do Sul, UNISC, Santa Cruz do Sul, RS, Brazil.
authors.forename: Giovana
authors.initials: G
authors.lastname: Pellegrin
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Denizar A S
authors.initials: DA
authors.lastname: Melo
authors.affiliation: Universidade de santa Cruz do Sul, UNISC, Santa Cruz do Sul, RS, Brazil.
authors.forename: Lia
authors.initials: L
authors.lastname: Possuelo
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Renan Trevisan
authors.initials: RT
authors.lastname: Jost
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Henrique Bregolin
authors.initials: HB
authors.lastname: Dias
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Márcio V F
authors.initials: MV
authors.lastname: Donadio
authors.affiliation: Laboratório de Pesquisa em Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil. Electronic address: jarbas@pucrs.br.
authors.forename: Jarbas R
authors.initials: JR
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016638:Critical Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*
chemical_list: D015415:Biomarkers; D020382:Interleukin-18; D053583:Interleukin-1beta
keywords: IL-18; IL-1β; Inflammation; Mortality; Sepsis