• J. Infect. Dis. · Jul 1995

    Plasma levels of cytokines in primary septic shock in humans: correlation with disease severity.

    • B Gårdlund, J Sjölin, A Nilsson, M Roll, C J Wickerts, and B Wretlind.
    • Section for Infectious Diseases, Karolinska Hospital, Stockholm, Sweden.
    • J. Infect. Dis. 1995 Jul 1; 172 (1): 296-301.

    AbstractThirteen patients (median age, 20 years) with life-threatening primary septic shock (10 meningococcal, 3 pneumococcal infections) were studied prospectively. All had a short history of sepsis (< or = 24 h) and no severe underlying disease. Two (15%) died. The logarithm of the initial plasma levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-1 receptor antagonist (ra), and plasminogen activator inhibitor (PAI)-1 correlated significantly with APACHE II scores (r2 = .67, .57, .68, .81, and .68, respectively). The plasma levels of endotoxin, TNF-alpha, IL-1 beta, and PAI-1 decreased toward normal levels within the first 24 h of treatment, but IL-6 and IL-1ra levels remained high until clinical recovery. On admission, the molar excess of IL-1ra to IL-1 beta was > 2000-fold in 11 of the 13 patients. Acute plasmapheresis in 11 of the 13 patients significantly increased the plasma clearance of TNF-alpha (P = .02).

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