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Titolo:
A MEMBRANE TNF-ALPHA TNFR RATIO CORRELATES TO MODS SCORE AND MORTALITY/
Autore:
PELLEGRINI JD; PUYANA JC; LAPCHAK PH; KODYS K; MILLERGRAZIANO CL;
Indirizzi:
UNIV MASSACHUSETTS,MED CTR,DEPT SURG,55 LAKE AVE N WORCESTER MA 01655 UNIV MASSACHUSETTS,MED CTR,DEPT SURG WORCESTER MA 01655
Titolo Testata:
Shock
fascicolo: 6, volume: 6, anno: 1996,
pagine: 389 - 396
SICI:
1073-2322(1996)6:6<389:AMTTRC>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
TUMOR-NECROSIS-FACTOR; RESPIRATORY-DISTRESS-SYNDROME; MULTIPLE-ORGAN DYSFUNCTION; TRAUMA PATIENTS MONOCYTES; SEPTIC SHOCK; FACTOR RECEPTOR; ALVEOLAR MACROPHAGES; CYTOKINE LEVELS; MESSENGER-RNA; SEPSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
38
Recensione:
Indirizzi per estratti:
Citazione:
J.D. Pellegrini et al., "A MEMBRANE TNF-ALPHA TNFR RATIO CORRELATES TO MODS SCORE AND MORTALITY/", Shock, 6(6), 1996, pp. 389-396

Abstract

This study hypothesizes that post-trauma elevated membrane-associatedtumor necrosis factor-alpha (mTNF) and decreased TNF receptor shedding may be more related to development of multiple organ dysfunction syndrome (MODS) than elevated secreted TNF-alpha. We also address severalof the possible reasons for the previous conflicting reports in studies correlating trauma patients' sera TNF-alpha levels to their clinical outcome. These are 1) the lack of an objective quantitative score ofclinical illness severity, 2) the lack of multiple TNF-alpha measurements in one patient to allow for trend analysis, 3) the lack of analysis of membrane-associated as well as secreted TNF-alpha levels, 4) thelack of concomitant analysis of soluble TNF-alpha receptors which maybind TNF-alpha in the serum, and 5) the possible requirement for morethan one dysfunction in monocyte (M phi) TNF-alpha production and regulation to initiate pathology. Here, the MODS score was used to quantitate patients' illness severity over the length of their intensive care unit (ICU) stay. Patients' and normals' monocytes (stimulated and unstimulated) were assessed for production of secreted as well as membrane-associated TNF-alpha (sTNF and mTNF) and for shed p75 TNF-alpha receptor (TNFR) levels. These parameters of M phi TNF-alpha production and regulation were correlated to the MODS score as an indicator of clinical outcome. There was no correlation between sTNF and MODS score (p = .9025). There was a correlation between increased mTNF (p = .057) ordecreased TNFR shedding (p = .0021) to increased MODS, but this lacked specificity. However, when the stimulated M phi production of mTNF and TNFR are expressed as the mTNF/TNFR ratio, an increased ratio correlates with high specificity to development of organ failure (p = .0002). These data indicate that a dual deregulation in M phi TNF-alpha production reflects increasing mTNF-alpha levels concomitant to decreasedM phi shedding of neutralizing TNFR and correlates with the development of MODS.

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Documento generato il 02/04/20 alle ore 05:59:58