High bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon, and elastase, in patients with adult respiratory distress syndrome after trauma, shock, or sepsis
Details
Serval ID
serval:BIB_D20E53F22661
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
High bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon, and elastase, in patients with adult respiratory distress syndrome after trauma, shock, or sepsis
Journal
American Review of Respiratory Disease
ISSN
1073-449X
0003-0805
0003-0805
Publication state
Published
Issued date
05/1992
Volume
145
Number
5
Pages
1016-22
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: May
Research Support, Non-U.S. Gov't --- Old month value: May
Abstract
Intrapulmonary activation of leukocytes and release of cellular mediators and enzymes are involved in the pathophysiology of the adult respiratory distress syndrome (ARDS). To investigate a possible role of local cytokines, we measured bronchoalveolar fluid (BALF) and plasma levels of tumor necrosis factor alpha (TNF-alpha) and its soluble inhibitors (sTNF-RI + RII), interleukin-1 beta (IL-1 beta), interferon-alpha (IFN-alpha), and granulocyte elastase in 14 patients at risk for ARDS and in 35 patients developing ARDS after trauma, sepsis, or shock. During clinical development of severe ARDS, BALF cytokines increased markedly: TNF-alpha from 116 +/- 36 to 10,731 +/- 5,048 pg/ml (mean +/- SEM), p = 0.001; sTNF-RI + RII from 3.7 +/- 1.4 to 24.6 +/- 2.6 ng/ml, p less than 0.05; and IL-1 beta from 7,746 +/- 5,551 to 42,255 +/- 19,176 pg/ml, p = 0.01. Plasma cytokines were not increased in most patients, nor were they correlated with the development or severity of ARDS. BALF elastase was higher in patients developing ARDS than in those at risk but not going into pulmonary failure (0.97 +/- 0.26 versus 0.28 +/- 0.13 U/ml, p = 0.026), and the highest values were observed in the early stages of severe ARDS (1.85 +/- 0.39 U/ml). BALF elastase levels correlated with IFN-alpha (r = 0.72, p less than 0.001). In conclusion, local release of TNF-alpha and IL-1 beta, possibly by pulmonary macrophages or other cells, and/or accumulation in the lung is associated with the development of ARDS.(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords
Bronchoalveolar Lavage Fluid/*chemistry
Humans
Infection/complications
Interferon-alpha/*analysis
Interleukin-1/*analysis
Leukocyte Elastase
Macrophages, Alveolar/*metabolism
Multiple Trauma/complications
Pancreatic Elastase/*analysis
Respiratory Distress Syndrome, Adult/epidemiology/etiology/*metabolism
Risk Factors
Shock, Hemorrhagic/complications
Tumor Necrosis Factor-alpha/*analysis/antagonists & inhibitors
Pubmed
Web of science
Create date
15/01/2008 15:28
Last modification date
20/08/2019 16:52