Pathan Nazima, Williams E John, Oragui E Emanuelle, Stephens Alick C, Levin Michael
Department of Paediatrics, Imperial College School of Medicine, St. Mary's Hospital, London, UK.
Crit Care Med. 2005 Aug;33(8):1839-44. doi: 10.1097/01.ccm.0000174097.38764.c8.
Interleukin-6 is strongly associated with disease severity and outcome in meningococcal septicemia. It is known that interleukin-6 exerts many of its effects via the soluble interleukin-6 receptor. By facilitating the activity of interleukin-6, it is likely that alterations in the levels of soluble interleukin-6 receptor in septic shock could affect the severity of disease. We aimed to investigate changes in the levels of interleukin-6 and soluble interleukin-6 receptor in acute meningococcal septicemia and the relationship with disease severity.
Laboratory investigation of interleukin-6 and soluble interleukin-6 receptor levels in children with meningococcal disease.
University hospital and laboratories.
Children with severe meningococcal disease requiring intensive care.
Blood samples obtained on admission to the intensive care unit were analyzed for interleukin-6 and soluble interleukin-6 receptor levels. Levels were also serially measured for up to 48 hrs in a subset of patients.
Cytokine levels were measured by enzyme-linked immunosorbent assay using mouse monoclonal antihuman antibodies. Acute meningococcemia is associated with a reduction in soluble interleukin-6 receptor levels in proportion to disease severity and is inversely related to interleukin-6 levels. Soluble interleukin-6 receptor returns to levels seen in normal donors following recovery from meningococcal septicemia.
Changes in the levels of interleukin-6 and soluble interleukin-6 receptor in acute meningococcemia may affect the severity and progression of multiple organ failure. Interventions to modulate this axis may improve outcome from meningococcal septic shock.
白细胞介素-6与脑膜炎球菌败血症的疾病严重程度及预后密切相关。已知白细胞介素-6通过可溶性白细胞介素-6受体发挥其多种作用。通过促进白细胞介素-6的活性，败血症休克中可溶性白细胞介素-6受体水平的改变可能会影响疾病的严重程度。我们旨在研究急性脑膜炎球菌败血症中白细胞介素-6和可溶性白细胞介素-6受体水平的变化及其与疾病严重程度的关系。
对患脑膜炎球菌病儿童的白细胞介素-6和可溶性白细胞介素-6受体水平进行实验室研究。
大学医院及实验室。
患有严重脑膜炎球菌病且需要重症监护的儿童。
对入住重症监护病房时采集的血样进行白细胞介素-6和可溶性白细胞介素-6受体水平分析。部分患者还连续测量长达48小时的水平。
使用小鼠单克隆抗人抗体通过酶联免疫吸附测定法测量细胞因子水平。急性脑膜炎球菌血症与可溶性白细胞介素-6受体水平降低相关，降低程度与疾病严重程度成正比，且与白细胞介素-6水平呈负相关。从脑膜炎球菌败血症康复后，可溶性白细胞介素-6受体水平恢复至正常供体的水平。
急性脑膜炎球菌血症中白细胞介素-6和可溶性白细胞介素-6受体水平的变化可能会影响多器官功能衰竭的严重程度和进展。调节该轴的干预措施可能会改善脑膜炎球菌败血症休克的预后。
