Relationship Between Alcohol Use Disorders, Cortisol Concentrations, And Cytokine Levels In Medical Intensive Care Unit Patients

Wit, Marjolein de; Wiaterek, Gregory; Gray, Nicole; Goulet, Keith; Gennings, Chris; Clore, John N.; Sweeney, Lori B.

doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a6132

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“…We also hypothesized that septic patients with AUD would have more depressed immune function as measured by higher anti-inflammatory cytokine IL10 and lower ratio of pro-inflammatory cytokines (that is, IL1β, IL6, and TNFα) to anti-inflammatory cytokine (that is, IL10). The results of this study have been published in abstract format [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between alcohol use disorders, cortisol concentrations, and cytokine levels in patients with sepsis

et al. 2010

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IntroductionPatients with alcohol use disorders (AUD) are at increased risk of developing sepsis and have higher mortality. AUD are associated with higher cortisol and anti-inflammatory cytokine profile. Higher cortisol increases risk of death in septic patients. The relationship between AUD and cortisol in septic patients is unknown. We aimed to study this relationship and postulated that AUD would be associated with higher cortisol and anti-inflammatory cytokine profile.MethodsThis was a prospective cohort study of 40 medical intensive care unit (ICU) patients admitted with sepsis. Cortisol, anti-inflammatory interleukin (IL) 10, and pro-inflammatory IL1β, IL6, tumor necrosis factor (TNF) α were measured.ResultsThirteen (32%) out of 40 patients had AUD. AUD patients had higher cortisol by univariate (39 microg/dl versus 24, P = 0.04) and multivariable analyses (44 microg/dl versus 23, P = 0.004). By univariate analyses, AUD patients had higher IL10 (198 picog/dl versus 47, P = 0.02) and IL6 (527 picog/ml versus 156, P = 0.048), but similar IL1β and TNFα. By multivariable analyses, AUD patients had higher IL10 (182 picog/dl versus 23, P = 0.049) but similar IL1β, IL6, and TNFα. AUD patients had lower IL1β/IL10 (univariate 0.01 versus 0.10, P = 0.04; multivariable 0.01 versus 0.03, P = 0.04), lower TNFα/IL10 (univariate 0.15 versus 0.52, P = 0.03; multivariable 0.11 versus 0.63, P = 0.01), but similar IL6/IL10.ConclusionsAUD are common diagnoses among medical ICU patients with sepsis. Patients with AUD have higher cortisol concentrations and have differences in cytokine expression. Future studies should seek to determine if these differences may explain the higher severity of illness seen in patients with sepsis and AUD.Trial registrationClinicalTrials.gov: NCT00615862

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Section: Introductionmentioning

confidence: 99%