Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: A marker for prognosis and future therapeutic options
Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: A marker for prognosis and future therapeutic options
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DOI：
10.1086/315214
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发表时间：
2000-01-01
影响因子：
6.4
通讯作者：
Skoutelis, A
中科院分区：
文献类型：
--
作者：
Gogos, CA;Drosou, E;Skoutelis, A
测定65例严重脓毒症患者血清促炎因子肿瘤坏死因子- α (TNF- α)、白细胞介素(IL)-1 β、IL-6、抗炎细胞因子IL- 10、IL-1受体拮抗剂（IL-1ra）和可溶性TNF受体（sTNFRs）的浓度，对所有患者进行临床和微生物学评估，并随访临床结果。脓毒症患者的促炎性和抗炎性细胞因子水平均显著升高。血清IL-10和tnf - α水平升高以及高IL-10与tnf - α比值与死亡相关，而在早期血流动力学恶化的患者中检测到较高水平的tnf - α、IL-6、IL-1ra和sTNFR，非幸存者中白细胞介素-10和IL-10: tnf - α比值仍然较高，而IL-10与败血症评分相似。尽管严重脓毒症患者的炎症和抗炎反应都大大增强，但抗炎细胞因子IL-10的持续过量产生是严重程度和致命结局的主要预测因素。
Serum concentrations of the proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1 beta, and IL-6, and the anti-inflammatory cytokine Il-10, and IL-1 receptor antagonists (IL-1ra) and soluble TNF receptors (sTNFRs) were measured in 65 patients with severe sepsis, All patients were evaluated clinically and microbiologically and were followed up for clinical outcome. Levels of both pro- and anti-inflammatory cytokines were significantly elevated in patients with sepsis. Elevated serum IL-10 and TNF-alpha levels and a high IL-10 to TNF-alpha ratio were associated with death, whereas higher levels of TNF-alpha, IL-6, IL-1ra, and sTNFR were detected in patients with an early hemodynamic deterioration, Interleukin-10 and IL-10 : TNF-alpha ratio remained higher in nonsurvivors, whereas IL-10 paralleled the sepsis score. Although both the inflammatory and anti-inflammatory response is profoundly augmented in patients with severe sepsis, the sustained overproduction of the anti-inflammatory cytokine IL-10 is the main predictor of severity and fatal outcome.