Regular Article
Prognostic Value of MIP-1α, TGF-β2, sELAM-1, and sVCAM-1 in Patients with Gram-Positive Sepsis

https://doi.org/10.1006/clin.1998.4523Get rights and content

Abstract

The aim of the present study was to evaluate the potential prognostic value of MIP-1α, TGF-β2, sELAM-1, and sVCAM-1 in patients with gram-positive sepsis. Twenty-eight patients with gram-positive sepsis were compared to 11 patients with gram-negative sepsis and 15 healthy volunteers. Sepsis was defined by the criteria of Boneet al.(Crit. Care Med.21, 5447–5463, 1993) and by isolation of at least two positive blood cultures with gram-positive/gram-negative bacteria. Plasma samples for determination of the immunological parameters were collected daily. Analysis of cytokines and adhesion molecules was performed on days 0 (day of sepsis criteria fulfillment), 4, and 7 (or 1 day before death). In the gram-positive group 10 of 28 patients died; in the gram-negative group 4 of 11 died. Only sELAM-1 plasma concentrations were found to be a useful early parameter in predicting patients’ outcome in gram-positive sepsis. sELAM-1 concentrations at the onset of the study (day 0) were significantly higher in the nonsurviving patients than those in the survivors. MIP-1α levels were significantly higher only on days 4 and 7. With regard to the measured plasma concentrations we believe that MIP-1α is not a useful parameter for predicting patients’ prognosis. The increase of sVCAM-1 might play a role in the pathogenesis of gram-positive sepsis; however, it could not be relied upon as an early prognostic parameter. The potential role of TGF-β2in the development of gram-positive sepsis could not be evaluated in the present study, whereas routine measurements of TGF-β2offered no additional prognostic information.

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