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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A predominantly anti-inflammatory cytokine profile is associated with disease severity in meningococcal sepsis
Intensive Care Medicine, Volume 31, No. 10, Year 2005
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Description
Objective: This study aimed to determine whether an anti-inflammatory profile in meningococcal disease is associated with an increased risk of severe disease or septic shock. Design and setting: Prospective observational study in a tertiary care children's hospital. Patients and participants: 63 children with confirmed meningococcal disease. Interventions: Plasma concentrations of interleukin-1 receptor antagonist (IL-1Ra), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-α (TNF) were assayed on admission. Receiver operator characteristic curve analysis was used to determine optimum thresholds for IL-1Ra:TNF, IL-1Ra:IL-6 and IL-1Ra:IL-8 ratios. Measurements and results: Median IL-1Ra:TNF and IL-1Ra:IL-6 ratios were significantly higher in severe disease with septic shock than in severe disease without septic shock and in non severe disease (IL-1Ra:TNF 263 vs. 185 vs. 108; IL-1Ra:IL-6 139 vs. 23 vs. 17). Median IL-1Ra:IL-8 ratios were not significantly different in the three groups. A significantly larger proportion of children with high IL-1Ra:TNF-α and IL-1Ra:IL-6 ratios developed severe disease with septic shock than those with a low ratios (95.2% vs. 4.8%; 76.2% vs. 23.8%). Conclusions: An anti-inflammatory profile appears to be associated with the development of severe disease and septic shock in meningococcal sepsis. This may imply that experimental new therapies of pro-inflammatory cytokine inhibition and anti-inflammatory cytokines in meningococcal disease could be detrimental. © Springer-Verlag 2005.
Authors & Co-Authors
Carrol, Enitan D.
Malawi, Blantyre
Malawi-liverpool-wellcome Trust Clinical Research Programme
United Kingdom, Liverpool
Alder Hey Children's Nhs Foundation Trust
United Kingdom, Liverpool
University of Liverpool
Thomson, Alistair P.J.
United Kingdom, Liverpool
Alder Hey Children's Nhs Foundation Trust
United Kingdom, Liverpool
University of Liverpool
Jones, Ashley P.
United Kingdom, Liverpool
Alder Hey Children's Nhs Foundation Trust
United Kingdom, Liverpool
University of Liverpool
Jeffers, Graham
United Kingdom, Liverpool
Alder Hey Children's Nhs Foundation Trust
Hart, Charles Anthony
United Kingdom, Liverpool
University of Liverpool
Statistics
Citations: 34
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1007/s00134-005-2787-x
ISSN:
03424642
Research Areas
Cancer
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study