Sepsis induced changes of adipokines and cytokines - septic patients compared to morbidly obese patients

Abstract

BackgroundHyperglycemia and insulin resistance frequently occur in critically ill and in morbidly obese (MO) patients. Both conditions are associated with altered serum levels of cytokines and adipokines. In addition, obesity related alterations in adipokine expression contribute to insulin resistance in metabolic syndrome. In this study we examined the serum adipocytokine profile in critically ill patients, MO patients, and healthy blood donors.Methods33 patients who fulfilled the clinical criteria for severe sepsis or septic shock (SP) were prospectively enrolled in this study. A multiplex analysis was performed to evaluate plasma levels of adiponectin, resistin, leptin, active PAI-1, MCP-1, IL-1 alpha, IL-6, IL-8, IL-10, and TNF-alpha in 33 critically ill patients, 37 MO patients and 60 healthy blood donors (BD).ResultsIn SP, adiponectin was significantly lowered and resistin, active PAI-1, MCP-1, IL-1 alpha, IL-6, IL-8, IL-10, and TNF-alpha were significantly elevated compared to BD. Leptin levels were unchanged. In MO, adiponectin and IL-8 were significantly lowered, leptin, active PAI-1, MCP-1, IL-1 alpha, IL-6, and IL-10 significantly elevated, whereas resistin was unaltered.In SP, adiponectin correlated negatively with BMI, SAPS II and SOFA scores, while resistin correlated positively with SAPS II and SOFA scores and leptin correlated positively with the BMI. Adiponectin was approximately equally diminished in SP and MO compared to BD. With the exception of active PAI-1, cytokine levels in SP were clearly higher compared to MO.ConclusionA comparable adipocytokine profile was determined in critically ill and MO patients. As in MO, SP showed reduced adiponectin levels and elevated MCP-1, active PAI-1, IL-1 alpha, IL-6, and IL-10 levels. Leptin is only elevated in MO, while resistin, IL-8, and TNF-alpha is only elevated in SP. As in MO patients, increased levels of proinflammatory cytokines and altered levels of adipokines may contribute to the development of insulin resistance in critically ill patients.

Adipocytokines in Severe Sepsis and Septic Shock

“…Many of these factors signal to organs of metabolic importance and the immune system and thus contribute to the phenomenon of insulin resistance [30] as proved for TNF-α and IL-6 [34,35]. A recent study demonstrated similar high adipocytokine profiles in septic patients as well as in morbidly obese [36]. Most validated data are available for Interleukins-1,-6,-8 and -10, TNF-α, Resistin, Adiponectin, Leptin, Leptin-Rezeptor, RBP4, Osteopontin, Visfatin, Omentin, Adipsin, Sfrp5, Adipophilin and VASPIN (visceral adipose-tissue-derived serine protease inhibitor).…”

Effect of Polygoni Multiflori Radix Water Extract on the Proinflammatory Mediators in RAW 264.7 Cells Induced by LPS

“…. 일반 적으로 IL-1α 은 염증의 원인이 될 뿐 아니라 발열과 패혈증 을 조장한다 23) . PM이 LPS로 유발된 대식세포의 IL-1α 생성 증가에 대한 영향을 알아보기 위하여 LPS와 함께 PM을 24 시간 동안 RAW 264.7 cells에 처리한 결과 25 ㎍/mL 이상 의 모든 농도에서 LPS에 의한 IL-1α 생성증가를 유의하게 억제하였다.…”

114. Neural and behavioral responses to low-grade inflammation

“…Human psychological disorders are not triggered by acute septic shock and levels of inflammatory cytokines reported in patients with psychological disorders are often higher than normal [9][10][11], but orders of magnitude lower than those induced by septic shock [12][13][14][15][16]. The levels of inflammatory cytokines in patients with various psychological disorders are actually more in line with those in patients with low-grade inflammation [17,18].…”