Serum TNF-related and weak inducer of apoptosis levels in septic shock patients.

Abstract

Capillary permeability is a tightly regulated feature of microcirculation in all organ beds. In sepsis, this feature is fundamentally altered. We have previously reported elevated levels of angiopoietin-2 in patients with septic shock, and have investigated tumor necrosis factor (TNF)-related and weak inducer of apoptosis (TWEAK), which mediates both angiogenesis and inflammation, in those patients. Enzyme-linked immunoassay was used to measure serum TWEAK levels in 20 patients with septic shock, all of whom were treated by direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX), and in 20 non-septic controls. The TWEAK levels were higher in patients with septic shock (192.8 ± 230.5 pg/mL) than in controls (84.1 ± 28.7 pg/mL, P = 0.043). Between 11 survivors and 10 non-survivors, there was no significant difference in the serum TWEAK levels before the DHP-PMX therapy. During DHP-PMX therapy, however, the serum TWEAK levels were significantly increased in non-survivors (142.2 ± 88.1 pg/mL to 399.0 ± 307.1 pg/mL, P = 0.022). There was a significant correlation between the serum TWEAK levels and white blood cell counts (r = 0.393, P < 0.001), platelet counts (r = 0.418, P < 0.001), or serum CRP levels (r = 0.259, P = 0.029), but there was no correlation between the serum TWEAK levels and blood pressure. The serum TWEAK levels were also correlated with the ratio of angiopoietin-2 to -1 (r = 0.464, P < 0.001). TWEAK may be a suitable marker of disease severity and mortality in septic patients, and TWEAK levels may be associated with vascular permeability via angiopoietin balance.

• Authors: Miho Nagai, Kouichi Hirayama, Itaru Ebihara, Takashi Higuchi, Masahiro Imaizumi, Hiroshi Maruyama, Yasunori Miyamoto, Tomoko Kakita, Yujiro Ogawa, Shogo Fujita, Homare Shimohata, Masaki Kobayashi
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 15 Issue 4 Pg. 342-8 (Aug 2011) ISSN: 1744-9987 [Electronic] Australia
• PMID: 21884467 (Publication Type: Journal Article)
• Copyright: © 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.

Chemical References

• Angiopoietin-1
• Angiopoietin-2
• Biomarkers
• Cytokine TWEAK
• TNFSF12 protein, human
• Tumor Necrosis Factors
• C-Reactive Protein
• Polymyxin B

Topics

• Aged
• Aged, 80 and over
• Angiopoietin-1 (metabolism)
• Angiopoietin-2 (metabolism)
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• Capillary Permeability
• Cytokine TWEAK
• Enzyme-Linked Immunosorbent Assay
• Female
• Hemoperfusion (methods)
• Humans
• Leukocyte Count
• Male
• Middle Aged
• Platelet Count
• Polymyxin B (chemistry)
• Severity of Illness Index
• Shock, Septic (blood, physiopathology, therapy)
• Survivors
• Tumor Necrosis Factors (blood)