Sensitivity and specificity of various markers of inflammation for the prediction of tumor necrosis factor-α and interleukin-6 in patients with sepsis

Oberhoffer, M.; Karzai, Waheedullah; Meier‐Hellmann, Andreas; Bögel, D.; Fassbinder, J.; Reinhart, Konrad

doi:10.1097/00003246-199909000-00018

Cited by 128 publications

(71 citation statements)

References 21 publications

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“…In spite of advances in modern intensive care medicine, sepsis with consecutive multiple organ failure still represents a major cause of death in the developed world (1 ). A central event in the pathophysiologic cascade of sepsis is the excessive systemic release of proinflammatory cytokines such as tumor necrosis factor-␣, interleukin-1 (IL-1), 3 and IL-6 in response to bacterial invasion (2 ).…”

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confidence: 99%

The Interleukin-6 G(−174)C Promoter Polymorphism Does Not Determine Plasma Interleukin-6 Concentrations in Experimental Endotoxemia in Humans

Endler¹,

Marsik²,

Joukhadar³

et al. 2004

Clinical Chemistry

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Background: Interleukin 6 (IL-6) is a pleiotropic cytokine that plays an essential role in the pathogenesis of acute and chronic infections. As the role of the IL-6 G(؊174)C polymorphism in determining serum concentrations of IL-6 is controversial, we studied the genotype-specific IL-6 response in a well-standardized model of systemic inflammation. Methods: A total of 76 healthy young males (age range, 19 -35 years) received a single bolus of 2 ng/kg endotoxin [lipopolysaccharide (LPS)] intravenously. Plasma IL-6 was measured by enzyme immunoassay at 0, 2, 6, and 24 h after LPS infusion, and the IL-6 promoter genotype was analyzed by a mutagenic separated PCR assay. Results: IL-6 increased 300-fold 2 h after LPS challenge and returned almost to normal within 24 h. Neither basal IL-6 nor the IL-6 response to LPS was significantly affected by the IL-6 promoter genotype. Conclusions: The IL-6 G(؊174)C promoter polymorphism does not significantly influence basal concentrations of IL-6 or peak IL-6 in human endotoxemia.

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confidence: 99%

The Interleukin-6 G(−174)C Promoter Polymorphism Does Not Determine Plasma Interleukin-6 Concentrations in Experimental Endotoxemia in Humans

Endler¹,

Marsik²,

Joukhadar³

et al. 2004

Clinical Chemistry

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“…Serum PCT measurement has allowed discrimination between episodes of fever caused by bacteria, fungi, and parasites from fevers of viral and noninfectious etiologies. [7][8][9] In addition, serum PCT levels have been found to correlate with severity in bacterial, fungal, and parasitic infections. 10,11 In this study of pediatric BMT recipients, it was our goal to address the following questions: (1) Are serum levels of PCT specifically elevated during a septic episode?…”

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confidence: 99%

Procalcitonin, C-reactive protein, and endotoxin after bone marrow transplantation: identification of children at high risk of morbidity and mortality from sepsis

Sauer

Tiede

Fuchs

et al. 2003

Bone Marrow Transplant

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Summary:We prospectively evaluated the capacity of serum procalcitonin (PCT), compared with serum levels of Creactive protein (CRP) and endotoxin, to identify children at high risk for mortality from sepsis after BMT. Of 47 pediatric bone marrow transplantation patients studied, 22 had an uneventful course post-transplant (Group 1), 17 survived at least one septic event (Group 2), and eight died from multiorgan failure (MOF) following septic shock (Group 3). Median concentrations of PCT over the course of the study were 1.3, 15.2, and 102.8 ng/ml, respectively, in each of the three groups (Po0.002 for each comparison). Median concentrations of CRP were 91, 213, and 260 mg/l, respectively (Po0.001 for Group 1 vs Group 2 and Group 3; P ¼ NS for Group 2 vs Group 3). Median concentrations of endotoxin were 0.21, 0.30, and 0.93 U/l, respectively (P ¼ NS for each comparison). Median concentrations of PCT, in contrast to serum CRP and endotoxin, correlated with the severity of sepsis (8.2 ng/ml in 'sepsis' and 22.3 ng/ml in 'severe sepsis', P ¼ 0.028) and provided useful prognostic information during septic episodes.

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“…A prospective study in a group of 175 patients admitted to the ICU revealed correlations between various mediators (IL-6, PCT, TNF-alpha) and the intensity of inflammatory response for multiple injury. The authors concluded that PCT was the best marker of inflammatory reaction to trauma [14]. If a second increase in PCT concentration is observed (unlike C-reactive protein), it should be treated as a sign of severe infection complicating trauma [15].…”

Section: -1 H (A) 24 H (B) 72 H (C) 120 H (D)mentioning

confidence: 99%

“…Peak values are observed in the first 24 hours and around the 3 rd day following trauma. High levels of PCT during the first days after injury are believed to be a prognostic factor in severe systemic inflammatory response syndrome (SIRS), infection or multiple organ dysfunction syndrome (MODS) [12][13][14][15][16].…”

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confidence: 99%

Changes of procalcitonin level in multiple trauma patients

Wojtaszek¹,

Staśkiewicz²,

Torres³

et al. 2014

Anaesthesiol Intensive Ther

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Background: Some aspects of the pathophysiology of complications in multiple-trauma patients still remain unclear. Mediators of inflammation have been postulated as playing a key role in being responsible for life threatening complications of multiple trauma patients. The objective of this study was to evaluate the prognostic value of procalcitonin (PCT) level in multiple trauma patients. Methods: A prospective study took place including patients with multiple trauma hospitalised in several hospital units. PCT level was measured in blood from 45 patients, aged 18-70 years using enzyme-linked immunoassay. The patients were divided into three groups: group I -individuals with multiple trauma with central nervous system injury; group II -those with multiple trauma without CNS injury; and group III -patients with isolated central nervous system injury. Results: Initial PCT levels were below 0.5 ng mL -1 regardless of the cause of trauma. In the 24 th hour of observation, a statistically significant increase of PCT concentration vs. initial levels was recorded in all groups of patients. Then PCT levels decreased significantly at the 3 rd measurement point in all groups, and they remained unchanged until the last measurement. The highest levels of PCT were observed in multiple trauma patients without CNS injury (group II). In this group of patients, a significantly longer duration of surgery in the post-trauma period affected PCT levels. PCT concentrations in patients who died were significantly greater than in survivors. Conclusions: A long lasting elevated concentration of procalcitonin in the post-traumatic period, or its repeated increase, is a good marker of developing complications observed earlier than clinical manifestations.

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Sensitivity and specificity of various markers of inflammation for the prediction of tumor necrosis factor-α and interleukin-6 in patients with sepsis

Abstract: PCT may be an early and better marker of elevated cytokines than the more classic criteria of inflammation.

Cited by 128 publications

References 21 publications

The Interleukin-6 G(−174)C Promoter Polymorphism Does Not Determine Plasma Interleukin-6 Concentrations in Experimental Endotoxemia in Humans

The Interleukin-6 G(−174)C Promoter Polymorphism Does Not Determine Plasma Interleukin-6 Concentrations in Experimental Endotoxemia in Humans

Procalcitonin, C-reactive protein, and endotoxin after bone marrow transplantation: identification of children at high risk of morbidity and mortality from sepsis

Changes of procalcitonin level in multiple trauma patients

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