Release of tumor necrosis factor alpha and its soluble receptor p55 in clinical septic syndrome.

Tumor necrosis factor alpha (TNF-alpha, cachectine) attracts much clinical interest when it looses its primary immune properties and, in the septic syndrome, initiates its destructive activity against host tissues. Behaviour of TNF-alpha and p55, its soluble receptor (sTNF-R p55), was studied in 50 patients with septic syndrome. Their clinical state was assessed by means of the APACHE II score. Group I consisted of 23 patients who had survived the infection. Twenty seven patients (54%) died, constituting group II. The concentrations of TNF-alpha and sTNF-R p55 were determined according to the ELISA method. The obtained results were referred to the severity of the patients' clinical state, their survival rate, the number of lactates and the quantity of the C-reactive protein in blood and the number of blood platelets and neutrophils. It has been documented that in septic syndrome patients with poor prognosis the concentration of TNF-alpha rises, together with a similar decrease of sTNF-R p55 concentration. This relationship is very important for the prognosis in septic syndrome.