Macrophage Migration Inhibitory Factor (MIF) and Manganese Superoxide Dismutase (MnSOD) as Early Predictors for Survival in Patients with Severe Sepsis or Septic Shock
Macrophage Migration Inhibitory Factor (MIF) and Manganese Superoxide Dismutase (MnSOD) as Early Predictors for Survival in Patients with Severe Sepsis or Septic Shock
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DOI：
10.1016/j.jss.2010.05.004
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发表时间：
2010-11-01
影响因子：
2.2
通讯作者：
Weigand, Markus A.
中科院分区：
文献类型：
--
作者：
Brenner, Thorsten;Hofer, Stefan;Weigand, Markus A.
背景。在重症监护医学中，严重败血症、感染性休克和由此导致的器官衰竭是最常见的死亡原因。炎症介质（白细胞介素-6/IL-6）、细胞粘附分子（细胞间粘附分子-1/ICAM-1、血管细胞粘附分子-1/VCAM-1）和氧化还原活性物质（锰超氧化物歧化酶/MnSOD、巨噬细胞迁移抑制因子/MIF）必须被认为是炎症过程中的中心枢纽。然而，其确切的病理生理功能和预后价值仍知之甚少。材料与方法。共有133人（87名严重脓毒症或脓毒性休克患者，28名腹部大手术术后患者，18名健康志愿者）参加了这项研究。脓毒症患者在脓毒症诊断后24 h内、48 h和120 h内采集血样；健康志愿者采集一次样本，术后患者采集一次样本。在所有患者中，我们使用酶联免疫吸附试验（ELISA）试剂盒检测血浆中IL-6、sICAM-1、sVCAM-1、MnSOD和MIF的水平。健康志愿者和术后患者的细胞粘附分子水平相当。此外，他们的氧化还原系统以类似的方式被激活，而在术后患者中IL-6显着升高。脓毒症患者血浆炎症介质、细胞粘附分子和氧化还原活性物质水平明显升高。在死亡的脓毒症患者中，血浆中MIF和MnSOD的水平与幸存者相比显著升高。因此，我们的研究结果表明，氧化还原活性物质可能在脓毒性炎症反应中发挥重要作用。MIF和MnSOD似乎是脓毒症患者生存的早期预测因子。(C) 2010爱思唯尔公司版权所有。
Background. Severe sepsis, septic shock, and resulting organ failure appear as the most common cause of death in intensive care medicine. Inflammatory mediators (interleukin-6/IL-6), cell adhesion molecules (intercellular adhesion molecule-1/ICAM-1, vascular cell adhesion molecule-1/VCAM-1), and redox active substances (manganese superoxide dismutase/MnSOD, macrophage migration inhibitory factor/MIF) must be considered to be central hubs in the inflammatory process. However, their exact pathophysiologic function and prognostic value are still poorly understood.Materials and Methods. In total, 133 individuals (87 patients with severe sepsis or septic shock, 28 postoperative patients after major abdominal surgery, 18 healthy volunteers) were enrolled in the study. Blood samples from septic patients were collected within 24 h after the time of sepsis diagnosis, and 48 and 120 h later; samples from healthy volunteers were collected once, and samples from postoperative patients once immediately after surgery. In all patients we measured plasma levels of IL-6, sICAM-1, sVCAM-1, MnSOD, and MIF using enzyme linked immunosorbent assay (ELISA) kits.Results. Healthy volunteers and postoperative patients showed comparable levels of cell adhesion molecules. Furthermore, their redox system was activated in a comparable manner, whereas in postoperative patients IL-6 was significantly elevated. Plasma levels of inflammatory mediators, cell adhesion molecules and redox active substances were significantly elevated in septic patients. In patients with sepsis who had died, plasma levels of MIF and MnSOD were significantly elevated in comparison with survivors.Conclusions. Our results therefore demonstrate that redox active substances may play an important role in the septic inflammatory response. MIF and MnSOD appear to be early predictors for survival in septic patients. (C) 2010 Elsevier Inc. All rights reserved.