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Tumor necrosis factor alpha (TNF-α) and sepsis: Evidence for a role in host defense

Tumornekrosefaktor alpha (TNF alpha) und Sepsis: Bedeutung für die Wirtsabwehr

Summary

Serum levels of TNF-alpha were evaluated in 29 patients with sepsis, using TNF-alpha sensitive L929 cells (sensitivity=15 pg/ml). Blood samples were collected serially at the first 24–36 h of symptoms. Seventeen patients had severe underlying disease and 12 patients had mild or no underlying disease. Shock was present in 25 patients. Overall mortality was 62.1%. TNF-alpha was detected in nine patients (range: 57.7–3,169 pg/ml). There was a tendency to detect TNF-alpha in patients with mild or no underlying disease (p=0.07). Detection of TNF-alpha was associated with survival (p=0.0003) even when adjusted for severity of underlying disease (p=0.005), shock (p=0.0005), coagulation abnormality (p=0.002) and immunosuppressive therapy (p=0.005), using a bivariate analysis. In this investigation, detection of circulating TNF-alpha was predictive of good outcome in septic patients, suggesting a role for this cytokine in host-defense against this kind of infection.

Zusammenfassung

Bei 29 Patienten mit Sepsis wurden die Serumspiegel von TNF-alpha mittels Bioassay mit TNFalpha-sensitiven L929 Zellen (untere Nachweisgrenze 15 pg/ml) bestimmt. In den ersten 24–36 Stunden nach Beginn der Symptome wurden seriell Blutproben entnommen. Bei 17 Patienten bestand eine schwere Grundkrankheit und bei 12 eine leichtere oder keine Grundkrankheit. Bei 25 der 29 Patienten war ein Schock festzustellen. Die Gesamtmortalität lag bei 62,1%. Bei neun Patienten war TNF-alpha (Bereich 57,7–3 169 pg/ml) nachzuweisen. Tendenziell war TNF-alpha eher bei Patienten mit leichten oder ohne Grundkrankheit nachzuweisen (p=0,07). Der Nachweis von TNF-alpha war mit Überleben verbunden (p=0,0003) auch wenn eine gepaarte Analyse unter Berücksichtigung des Schweregrades der Grundkrankheit (p=0,005), Schock (p=0,0005), einer Gerinnungsstörung (p=0,002) oder immunsuppressiven Therapie (p=0,005) durchgeführt wurde. In dieser Studie erwies sich der Nachweis von TNF-alpha als prädiktiver Faktor für einen günstigen Verlauf bei Sepsispatienten, so daß angenommen werden muß, daß dieses Zytokin bei dieser Infektionsform eine Funktion in der Wirtsabwehr hat.

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Correspondence to R. Salomão M. D..

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Rigato, O., Ujvari, S., Castelo, A. et al. Tumor necrosis factor alpha (TNF-α) and sepsis: Evidence for a role in host defense. Infection 24, 314–318 (1996). https://doi.org/10.1007/BF01743367

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Keywords

  • Tumor Necrosis Factor
  • Host Defense
  • Immunosuppressive Therapy
  • Tumor Necrosis Factor Alpha
  • Necrosis Factor Alpha