Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia.
OBJECTIVE: To examine whether cytokine concentrations change in the pulmonary compartment during the development of ventilator-associated pneumonia (VAP). DESIGN: Non-directed bronchial lavage (NBL) was performed every 48 h in critically ill mechanically ventilated patients. Serial measurements of...
| Main Authors: | , , , , , , , |
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| 格式: | Journal article |
| 語言: | English |
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2004
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| _version_ | 1826277181746053120 |
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| author | Millo, J Schultz, M Williams, C Weverling, G Ringrose, T Mackinlay, C van der Poll, T Garrard, C |
| author_facet | Millo, J Schultz, M Williams, C Weverling, G Ringrose, T Mackinlay, C van der Poll, T Garrard, C |
| author_sort | Millo, J |
| collection | OXFORD |
| description | OBJECTIVE: To examine whether cytokine concentrations change in the pulmonary compartment during the development of ventilator-associated pneumonia (VAP). DESIGN: Non-directed bronchial lavage (NBL) was performed every 48 h in critically ill mechanically ventilated patients. Serial measurements of the cytokines tumor necrosis factor (TNF) alpha, interleukin (IL)-1alpha, IL-1beta, IL-6, and IL-10 and the cytokine inhibitors soluble TNFalpha receptor type I (sTNFalphaRI), IL-1 receptor antagonist (IL-1Ra) and soluble IL-1 receptor II (sIL-1RII) were performed on the NBL fluid and matching plasma samples by ELISA. SETTING: An adult medical and surgical university hospital intensive care unit. PATIENTS: Nine patients who developed VAP and nineteen patients who did not develop VAP served as controls. INTERVENTIONS: None. RESULTS: Plasma concentrations of the measured cytokines and cytokine inhibitors did not change significantly in any patients. In control patients, NBL fluid concentrations of sIL-1RII decreased significantly over time (P=0.01). In patients who developed VAP, NBL fluid concentrations of TNFalpha, sTNFalphaRI, IL-1alpha, and IL-1beta increased significantly (P=0.002, P=0.03, P=0.04 and P=0.02, respectively). Furthermore, NBL fluid/plasma concentration ratios for TNFalpha, sTNFalphaRI, IL-1alpha, IL-1Ra and IL-6 increased significantly as VAP developed (P=0.001, P=0.001, P=0.04, P=0.03, and P=0.04, respectively). CONCLUSION: Our results suggest that the production of important cytokines and cytokine inhibitors is compartmentalised within the lung in critically ill mechanically ventilated patients who develop VAP. |
| first_indexed | 2024-03-06T23:25:03Z |
| format | Journal article |
| id | oxford-uuid:6a1289d7-d081-42cb-9053-115d878fe94a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:25:03Z |
| publishDate | 2004 |
| record_format | dspace |
| spelling | oxford-uuid:6a1289d7-d081-42cb-9053-115d878fe94a2022-03-26T18:55:07ZCompartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6a1289d7-d081-42cb-9053-115d878fe94aEnglishSymplectic Elements at Oxford2004Millo, JSchultz, MWilliams, CWeverling, GRingrose, TMackinlay, Cvan der Poll, TGarrard, C OBJECTIVE: To examine whether cytokine concentrations change in the pulmonary compartment during the development of ventilator-associated pneumonia (VAP). DESIGN: Non-directed bronchial lavage (NBL) was performed every 48 h in critically ill mechanically ventilated patients. Serial measurements of the cytokines tumor necrosis factor (TNF) alpha, interleukin (IL)-1alpha, IL-1beta, IL-6, and IL-10 and the cytokine inhibitors soluble TNFalpha receptor type I (sTNFalphaRI), IL-1 receptor antagonist (IL-1Ra) and soluble IL-1 receptor II (sIL-1RII) were performed on the NBL fluid and matching plasma samples by ELISA. SETTING: An adult medical and surgical university hospital intensive care unit. PATIENTS: Nine patients who developed VAP and nineteen patients who did not develop VAP served as controls. INTERVENTIONS: None. RESULTS: Plasma concentrations of the measured cytokines and cytokine inhibitors did not change significantly in any patients. In control patients, NBL fluid concentrations of sIL-1RII decreased significantly over time (P=0.01). In patients who developed VAP, NBL fluid concentrations of TNFalpha, sTNFalphaRI, IL-1alpha, and IL-1beta increased significantly (P=0.002, P=0.03, P=0.04 and P=0.02, respectively). Furthermore, NBL fluid/plasma concentration ratios for TNFalpha, sTNFalphaRI, IL-1alpha, IL-1Ra and IL-6 increased significantly as VAP developed (P=0.001, P=0.001, P=0.04, P=0.03, and P=0.04, respectively). CONCLUSION: Our results suggest that the production of important cytokines and cytokine inhibitors is compartmentalised within the lung in critically ill mechanically ventilated patients who develop VAP. |
| spellingShingle | Millo, J Schultz, M Williams, C Weverling, G Ringrose, T Mackinlay, C van der Poll, T Garrard, C Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia. |
| title | Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia. |
| title_full | Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia. |
| title_fullStr | Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia. |
| title_full_unstemmed | Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia. |
| title_short | Compartmentalisation of cytokines and cytokine inhibitors in ventilator-associated pneumonia. |
| title_sort | compartmentalisation of cytokines and cytokine inhibitors in ventilator associated pneumonia |
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