Interleukin-6 serum level assessment using a new qualitative point-of-care test in sepsis: A comparison with ELISA measurements

Schefold, Joerg C.; Hasper, Dietrich; Haehling, Stephan von; Meisel, Christian; Reinke, Petra; Schlosser, Hans-Georg

doi:10.1016/j.clinbiochem.2008.03.008

Cited by 25 publications

(19 citation statements)

References 32 publications

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“…13 Several studies have demonstrated an early rise in IL-6 in neonatal sepsis. 14,15 IL-6 has been shown to be rapidly released in response to infection, with peak serum levels within 2 h, often before the onset of clinical symptoms and before routine laboratory tests, such as measurement of high-sensitivity CRP (hsCRP), result positive 16 We recorded IL-6 sensitivity and specificity of 92.3 and 90.48%, respectively, with a cut-off value of 40.5 pg/mL. Different authors have used different cut-off values of IL-6 for the diagnosis of EOS.…”

Section: Discussionmentioning

confidence: 99%

“…20 In the study carried out by Schefold et al, the sensitivity and specificity of IL-6 was found to be 82.6 and 86.5%, respectively. 16 Hematologic markers which increase in response to infection include microscopic examination of the blood for white blood cells: total and differential leukocyte count, absolute neutrophil count, and immature to total neutrophil (I:T) ratio. Different authors found significant heterogeneity in the predictive value of hematologic indexes of sepsis screen.…”

Section: Discussionmentioning

confidence: 99%

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Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

Basu

Dewangan

Anupurva

et al. 2012

Microbiol Res (Pavia)

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Use of empirical antibiotics in neonates with risk factors of early-onset neonatal sepsis (EOS) is a common practice. A laboratory parameter is needed to help in the accurate diagnosis of EOS to avoid unnecessary use of antibiotics. The aim of this prospective observational cohort study was to compare the statistical validity of cord blood interleukin-6 (IL-6) with conventional sepsis screening as an early diagnostic marker for EOS. Eighty-seven neonates with antenatal risk factors for sepsis were followed up for 72 h for the development of EOS. Cord blood was collected for measurement of IL-6 concentrations. Blood culture and conventional sepsis screening (total leukocyte count, absolute neutrophil count, C-reactive protein and micro-erythrocyte sedimentation rate) were sent for analysis soon after delivery. The study group comprised of symptomatic neonates with positive blood culture (n=36). An equal number of gestational-age matched asymptomatic neonates without risk factor of sepsis served as controls. Statistical validity of IL-6 was compared with sepsis screening parameters as the diagnostic marker for EOS. Gram negative organisms were the predominant cause of EOS. The most commonly isolated organism was Acinetobacter baumanii. The sensitivity and specificity of IL-6 with a cut-off value of 40.5 pg/mL and area under curve of 0.959 were 92.3 and 90.48%, respectively. In contrast, the sensitivity and specificity of different parameters of sepsis screening ranged from 37.5-68.75% and 47.95-57.35%, respectively. In conclusion, cord blood IL-6 can be used as a highly sensitive and specific early diagnostic marker of EOS at a cut-off concentration of 40.5 pg/mL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

Basu

Dewangan

Anupurva

et al. 2012

Microbiol Res (Pavia)

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“…Monitoring the patient's plasma concentration of proinflammatory cytokines is a relatively cheap and easy test, which therefore may be helpful in the introduction of immunostimulatory treatment (Schefold et al 2008). Although huge efforts have been made, the concentration of no single inflammatory mediator has been identified as a reliable marker of the patient clinical state.…”

Section: Circulating Mediatorsmentioning

confidence: 99%

Sepsis Immunopathology: Perspectives of Monitoring and Modulation of the Immune Disturbances

Skirecki

Borkowska-Zielińska

Złotorowicz

et al. 2012

Arch. Immunol. Ther. Exp.

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Septic syndromes are the main cause of death in the intensive care units and although the mortality rates is slowly decreasing, the occurrence of the disease has been increasing. The pathogenesis of sepsis includes countless disturbances of the host immune system starting with a harmful, infection-triggered exaggerated inflammatory cascade, followed by the development of an immunoparalysis state. The latter contributes to the failure in pathogen eradication and leads to secondary infections, which are often the cause of fatal complications. In this review, we consider different novel therapeutic strategies for restoration of immune function. The use of glucocorticoids, intravenous immunoglobulins, heparin, recombinant human activated protein C, granulocyte macrophage colony-stimulating factor, granulocyte colony-stimulating factor, interferon-γ, statins, macrolides and high-volume hemofiltration are discussed. Even though some clinical trials of these regimens are promising, the key to their successful application seems to be the precise monitoring of the status of immune system followed by implementation of the adequate therapy. Thus, in this paper we present disturbances in the immune system in the course of human sepsis, with special attention to the parameters that could be monitored and serve as markers for immunomodulatory therapies. We conclude by briefly presenting the current sepsis treatment strategy.

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“…In current clinical practice, IL-6 measurements are available at the bedside within 20 min of blood sample [70,71]. Similar assays are not yet available for other cytokines.…”

Section: Limitationsmentioning

confidence: 99%

Modeling and Hemofiltration Treatment of Acute Inflammation

et al. 2016

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Abstract:The body responds to endotoxins by triggering the acute inflammatory response system to eliminate the threat posed by gram-negative bacteria (endotoxin) and restore health. However, an uncontrolled inflammatory response can lead to tissue damage, organ failure, and ultimately death; this is clinically known as sepsis. Mathematical models of acute inflammatory disease have the potential to guide treatment decisions in critically ill patients. In this work, an 8-state (8-D) differential equation model of the acute inflammatory response system to endotoxin challenge was developed. Endotoxin challenges at 3 and 12 mg/kg were administered to rats, and dynamic cytokine data for interleukin (IL)-6, tumor necrosis factor (TNF), and IL-10 were obtained and used to calibrate the model. Evaluation of competing model structures was performed by analyzing model predictions at 3, 6, and 12 mg/kg endotoxin challenges with respect to experimental data from rats. Subsequently, a model predictive control (MPC) algorithm was synthesized to control a hemoadsorption (HA) device, a blood purification treatment for acute inflammation. A particle filter (PF) algorithm was implemented to estimate the full state vector of the endotoxemic rat based on time series cytokine measurements. Treatment simulations show that: (i) the apparent primary mechanism of HA efficacy is white blood cell (WBC) capture, with cytokine capture a secondary benefit; and (ii) differential

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Interleukin-6 serum level assessment using a new qualitative point-of-care test in sepsis: A comparison with ELISA measurements

Cited by 25 publications

References 32 publications

Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

Sepsis Immunopathology: Perspectives of Monitoring and Modulation of the Immune Disturbances

Modeling and Hemofiltration Treatment of Acute Inflammation

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