Krafte-Jacobs B, Bock G H
Department of Critical Care, Children's National Medical Center, Washington, DC, USA.
Crit Care Med. 1996 Sep;24(9):1455-9. doi: 10.1097/00003246-199609000-00005.
To investigate a possible relationship between plasma erythropoietin and interleukin-6 (IL-6) in critically ill children with sepsis or septic shock. To examine the modulatory effects of plasma from these patients on erythropoietin production in vitro, employing a cell culture system that uses the erythropoietin-producing Hep 3B cell line.
A prospective, controlled clinical and laboratory study.
A pediatric intensive care unit and research laboratory facility at a children's hospital.
Children admitted to the pediatric intensive care unit with the diagnosis of sepsis or septic shock (n = 16), and control patients without infection or anemia (n = 16) were admitted to the study.
None.
Blood samples were obtained from 16 children with sepsis or septic shock, and 16 age-matched controls. Plasma erythropoletin and IL-6 concentrations were measured using an enzyme-linked immunoassay. Plasma erythropoietin concentrations were significantly higher in children with sepsis or septic shock (120 +/- 26 mlU/mL) than in controls (10 +/- 2 mlU/mL) (p < .001). Plasma IL-6 concentrations were greater in children diagnosed with sepsis or septic shock (12,405 +/- 6662 pg/mL) than in control patients (7 +/- 1 pg/mL) (p < .001), and higher in septic shock patients (27,469 +/- 13,647 pg/mL) than sepsis patients (688 +/- 258 pg/mL) (p = .03). Hep 3B cells were incubated under hypoxic conditions in media containing plasma from control patients, or patients diagnosed with sepsis or septic shock. Media concentrations of erythropoietin were measured using an enzymelinked immunoassay. Hep 3B cells incubated with plasma from patients diagnosed with sepsis or septic shock produced more erythropoietin (216 +/- 23 mlU/mL) than Hep 3B cells incubated under the same conditions in media containing plasma from control patients (152 +/- 11 mlU/mL) (p = .04). Hypoxic Hep 3B cell erythropoietin production in media incubated with plasma from patients diagnosed with sepsis or septic shock correlated significantly (although weakly) with plasma IL-6 values from these same patients (p = .03, r2 = .28).
Plasma erythropoietin and IL-6 values are increased in critically ill children with sepsis or septic shock in comparison with controls. The data indicate that one or more plasma factors are responsible for stimulation of hypoxia-induced erythropoietin production in the Hep 3B cell line and suggest a possible role for IL-6 in the regulation of erythropoletin production in critically ill children with sepsis or septic shock.
研究脓毒症或脓毒性休克危重症患儿血浆促红细胞生成素与白细胞介素-6（IL-6）之间可能存在的关系。采用使用促红细胞生成素产生细胞系Hep 3B的细胞培养系统，检测这些患者血浆对体外促红细胞生成素产生的调节作用。
一项前瞻性对照临床和实验室研究。
一家儿童医院的儿科重症监护病房和研究实验室设施。
诊断为脓毒症或脓毒性休克而入住儿科重症监护病房的患儿（n = 16），以及无感染或贫血的对照患者（n = 16）纳入研究。
无。
采集16例脓毒症或脓毒性休克患儿及16例年龄匹配对照者的血样。采用酶联免疫吸附测定法测量血浆促红细胞生成素和IL-6浓度。脓毒症或脓毒性休克患儿的血浆促红细胞生成素浓度（120±26 mIU/mL）显著高于对照组（10±2 mIU/mL）（p <.001）。诊断为脓毒症或脓毒性休克患儿的血浆IL-6浓度（12,405±6662 pg/mL）高于对照患者（7±1 pg/mL）（p <.001），脓毒性休克患者（27,469±13,647 pg/mL）高于脓毒症患者（688±258 pg/mL）（p = .03）。将Hep 3B细胞在缺氧条件下于含有对照患者血浆、或诊断为脓毒症或脓毒性休克患者血浆的培养基中孵育。采用酶联免疫吸附测定法测量培养基中促红细胞生成素的浓度。与在相同条件下于含有对照患者血浆的培养基中孵育的Hep 3B细胞相比，与诊断为脓毒症或脓毒性休克患者血浆一起孵育的Hep 3B细胞产生更多促红细胞生成素（216±23 mIU/mL）（p = .04）。与诊断为脓毒症或脓毒性休克患者血浆一起孵育的培养基中，缺氧Hep 3B细胞促红细胞生成素的产生与这些相同患者的血浆IL-6值显著（尽管较弱）相关（p = .03，r2 = .28）。
与对照组相比，脓毒症或脓毒性休克危重症患儿的血浆促红细胞生成素和IL-6值升高。数据表明，一种或多种血浆因子可刺激Hep 3B细胞系中缺氧诱导的促红细胞生成素产生，并提示IL-6在脓毒症或脓毒性休克危重症患儿促红细胞生成素产生调节中可能发挥作用。
