Cytokine profiles as markers of disease severity in sepsis: a multiplex analysis.
Cytokine profiles as markers of disease severity in sepsis: a multiplex analysis.
复制标题
DOI：
10.1186/cc5783
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Bozza PT
中科院分区：
文献类型：
--
作者：
Bozza FA;Salluh JI;Japiassu AM;Soares M;Assis EF;Gomes RN;Bozza MT;Castro-Faria-Neto HC;Bozza PT
目前缺乏准确、容易获得、有效的脓毒症疾病严重程度生物标志物，这是试图将患者分成同质组以研究发病机制或开发治疗干预措施时的一个重要限制。本研究的目的是用一种同时检测17种细胞因子的多重系统来测定严重脓毒症患者血浆中的细胞因子谱。这是一项在四家三级医院进行的前瞻性队列研究。共有60名最近被诊断为严重脓毒症的患者被纳入其中。采集血浆样本进行细胞因子浓度测定。对17种细胞因子(IL-1β、IL-2、IL-4、IL-5、IL-6、IL-7、IL-8、IL-10、IL-12、IL-13、IL-17、干扰素-γ、粒细胞集落刺激因子、粒细胞集落刺激因子、单核细胞趋化蛋白-1、巨噬细胞炎性蛋白-1和肿瘤坏死因子-α)进行多重分析。细胞因子浓度与严重脓毒症或感染性休克的存在、器官衰竭的严重程度和演变以及早期和晚期死亡有关。感染性休克患者IL-1β、IL-6、IL-7、IL-8、IL-10、IL-13、干扰素-γ、单核细胞趋化蛋白-1和肿瘤坏死因子-α水平明显高于严重脓毒症患者。细胞因子浓度与器官功能障碍的严重程度和演变有关。IL-8、MCP-1与序贯器官衰竭评分相关性最好。此外，前24小时的IL-6、IL-8和G-CSF浓度预示着器官功能障碍的恶化或器官功能障碍在第三天未能改善。在预测死亡率方面，细胞因子IL-1、β、IL-4、IL-6、IL-8、单核细胞趋化蛋白-1和粒细胞集落刺激因子对早期死亡(48h)的预测准确性较好，其中以IL-8和单核细胞趋化蛋白-1预测28d死亡率的准确性最高。在多因素分析中，只有MCP-1与预后独立相关。在这一探索性分析中，我们证明了使用多细胞因子分析平台可以识别与脓毒症严重程度、器官衰竭演变和死亡相关的不同细胞因子谱。
The current shortage of accurate and readily available, validated biomarkers of disease severity in sepsis is an important limitation when attempting to stratify patients into homogeneous groups, in order to study pathogenesis or develop therapeutic interventions. The aim of the present study was to determine the cytokine profile in plasma of patients with severe sepsis by using a multiplex system for simultaneous detection of 17 cytokines. This was a prospective cohort study conducted in four tertiary hospitals. A total of 60 patients with a recent diagnosis of severe sepsis were included. Plasma samples were collected for measurement of cytokine concentrations. A multiplex analysis was performed to evaluate levels of 17 cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, interferon-γ, granulocyte colony-stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor, monocyte chemoattractant protein [MCP]-1, macrophage inflammatory protein-1 and tumour necrosis factor-α). Cytokine concentrations were related to the presence of severe sepsis or septic shock, the severity and evolution of organ failure, and early and late mortality. Concentrations of IL-1β, IL-6, IL-7, IL-8, IL-10, IL-13, interferon-γ, MCP-1 and tumour necrosis factor-α were significantly higher in septic shock patients than in those with severe sepsis. Cytokine concentrations were associated with severity and evolution of organ dysfunction. With regard to the severity of organ dysfunction on day 1, IL-8 and MCP-1 exhibited the best correlation with Sequential Organ Failure Assessment score. In addition, IL-6, IL-8 and G-CSF concentrations during the first 24 hours were predictive of worsening organ dysfunction or failure of organ dysfunction to improve on day three. In terms of predicting mortality, the cytokines IL-1β, IL-4, IL-6, IL-8, MCP-1 and G-CSF had good accuracy for predicting early mortality (< 48 hours), and IL-8 and MCP-1 had the best accuracy for predicting mortality at 28 days. In multivariate analysis, only MCP-1 was independently associated with prognosis. In this exploratory analysis we demonstrated that use of a multiple cytokine assay platform allowed identification of distinct cytokine profiles associated with sepsis severity, evolution of organ failure and death.
登录
查看更多内容
影响因子：
8.8
作者：
Levy, MM;Fink, MP;Ramsay, G
通讯作者：
Ramsay, G
影响因子：
8.8
作者：
Marshall, JC;Vincent, JL;Reinhart, K
通讯作者：
Reinhart, K
影响因子：
8.8
作者：
Cohen, J;Guyatt, G;Opal, S
通讯作者：
Opal, S
影响因子：
8.8
作者：
Levy, MM;Macias, WL;Williams, MD
通讯作者：
Williams, MD
影响因子：
3.1
作者：
Oberholzer, A;Souza, SM;Moldawer, LL
通讯作者：
Moldawer, LL