Increased interleukin-8 concentrations in the pulmonary edema fluid of patients with acute respiratory distress syndrome from sepsis
Increased interleukin-8 concentrations in the pulmonary edema fluid of patients with acute respiratory distress syndrome from sepsis
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DOI：
10.1097/00003246-199609000-00004
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发表时间：
1996-09-01
影响因子：
8.8
通讯作者：
Matthay, MA
中科院分区：
文献类型：
--
作者：
Miller, EJ;Cohen, AB;Matthay, MA
目的：验证脓毒性vs非脓毒性急性呼吸窘迫综合征（ARDS）患者肺水肿液和血浆中白细胞介素-8 （IL-8）浓度显著升高的假设，设计：对先前收集的水肿液和血浆中IL-8浓度的前瞻性测量，背景：某大学医学中心成人重症监护病房。27例ARDS患者（16例为脓毒性病因，9例为非脓毒性病因），8例为静压性肺水肿。所有ARDS患者的肺水肿液中均存在IL-8，但合并败血症的ARDS患者的肺水肿液中IL-8的中位浓度（84.2 ng/mL, n = 16）高于未合并败血症的ARDS患者（14.8 ng/mL, n = 11） （p < 0.05），心源性水肿患者的IL-8浓度（5.0 ng/mL, n = 8, p < 0.05）显著低于ARDS患者。脓毒症患者IL-8的中位血浆浓度升高（1.3 ng/mL），但与非脓毒症ARDS患者（0.35 ng/mL） （p = 0.14）或心力衰竭患者（0.21 ng/mL）相比，IL-8的中位血浆浓度并未显著升高。肺水肿液中高浓度的IL-8，加上血浆中相对较低的IL-8浓度，表明肺是急性呼吸窘迫综合征患者IL-8的主要来源。脓毒症引起的急性呼吸窘迫综合征患者肺水肿液中IL-8浓度显著升高，表明这组患者可能特别适合用于抑制这一重要趋化因子活性的潜在试验。
Objective: To test the hypothesis that significantly higher concentrations of interleukin-8 (IL-8) are found in the pulmonary edema fluid and plasma of patients with a septic vs, a nonseptic etiology of acute respiratory distress syndrome (ARDS),Design: Prospective measurement of IL-8 concentrations in previously collected edema fluid and plasma,Setting: Adult intensive care units at a university medical center,Patients: There were 27 patients with ARDS (16 patients with a septic etiology and nine patients with a nonseptic etiology) plus eight control patients with hydrostatic pulmonary edema,Measurements and Main Results: IL-8 was present in the pulmonary edema fluid of all patients with ARDS, but the median IL-8 concentration was higher in the edema fluid of patients with ARDS associated with sepsis (84.2 ng/mL, n = 16) compared with the ARDS patients without sepsis (14.8 ng/mL, n = 11) (p < .05), In patients with cardiogenic edema, IL-8 concentration (5.0 ng/mL, n = 8, p < .05) was significantly lower than those values in patients with ARDS, Median plasma concentration of IL-8 was increased in septic individuals (1.3 ng/mL), but these concentrations were not significantly higher than in patients with a nonseptic etiology of ARDS (0.35 ng/mL) (p = .14) or those patients with cardiac failure (0.21 ng/mL),Conclusions: The high concentrations of IL-8 in pulmonary edema fluid, coupled with the relatively low concentrations of IL-8 in the plasma, suggest that the lung was the primary source of IL-8 in the patients with ARDS, The markedly increased concentrations of IL-8 in the pulmonary edema fluid of patients with ARDS from sepsis suggests that this group of patients may be particularly suitable for potential trials directed at inhibiting the activity of this important chemokine.