Significance of the CC chemokine RANTES in patients with haematological malignancy: results from a prospective observational study

Abstract

Summary Regulated on activation, normal T cell expressed and secreted (RANTES) serum concentrations were explored in a prospective observational study of haematological‐malignancy patients undergoing chemotherapy. During systemic inflammatory response syndrome/sepsis or severe sepsis/septic shock mean concentrations were 3394 or 2939 pg/ml, respectively, significantly lower than those prior to fever (6031 pg/ml) (P < 0·01) or at bone‐marrow recovery (6433 pg/ml, P < 0·001). Levels during febrile‐bacteraemia were lower compared with febrile‐non‐bacteraemia (3022 pg/ml vs. 5111 pg/ml, respectively, P < 0·01). Sixty‐three of 67 infection episodes resolved despite low RANTES concentrations, suggesting RANTES is not a prerequisite for recovering from most infection events. However, in four patients dying from septic shock associated with aspergillosis, candidosis, pneumonia or infectious colitis, RANTES concentrations were persistently and extremely low (1629 pg/ml), compared with four matched patients who recovered (6780 pg/ml). RANTES concentrations were highly correlated to platelet counts [median correlation coefficient 0·82 (inter‐quartile range, 0·72–0·89)]. RANTES concentrations rose 4·5 d before platelet counts (P < 0·001), suggesting an additional extra‐platelet source for RANTES. A nested mixed model regression analysis demonstrated that platelet level was the only independent variable associated with RANTES concentration (P < 0·001) among steroids, haematopoietic‐colony‐stimulating‐factor, recombinant‐human‐interleukin‐11, sepsis status, and neutropenia. A significant ‘hypo‐RANTES’ serum environment occurs following chemotherapy, is driven by thrombocytopenia, but does not affect the ability of most patients to recover from infection.

Early Prediction of Sepsis-Induced Disseminated Intravascular Coagulation with Interleukin-10, Interleukin-6, and RANTES in Preterm Infants

“…Plasma RANTES concentrations decreased significantly in preterm infants with severe sepsis and DIC. A similar phenomenon has also been observed in adult patients (8,27 ) and might be related to the thrombocytopenic state associated with DIC, as platelets have been found to be a rich source of RANTES (8,37 ). Platelet surfaces express CD40 costimulatory molecules (38,39 ), which interact with the CD154 counter-receptor on activated T lymphocytes, thereby triggering the release of preformed RAN-TES (40 ).…”

Biomarkers of Plasmodium falciparum Infection during Pregnancy in Women Living in Northeastern Tanzania

“…Thrombocytopenia is frequent in severe malaria cases and is associated with increased mortality in children [40]. Since platelets are a major reservoir of RANTES in the circulation [41], it has been suggested that lower levels of RANTES in patients with severe malaria may be due to parasite-induced thrombocytopenia [42]. Of relevance to our study is the fact that pregnant women with acute uncomplicated malaria become more thrombocytopenic than non-pregnant women [43].…”

Prognostic value of clinical and immunological markers in acute phase of SFTS virus infection

“…The low level of tPAI‐1 might be one of the factors in the pathogenesis of haemorrhage. Low serum levels of PDGF‐BB in SFTS might be related to the decrease in circulating platelets . The level of the proinflammatory cytokine GRO was lower in fatal than in non‐fatal cases of Rift Valley fever .…”