Elsevier

Cytokine

Volume 7, Issue 7, October 1995, Pages 746-752
Cytokine

Regular article
Interleukin 8-related neutrophil elastase and the severity of the adult respiratory distress syndrome

https://doi.org/10.1006/cyto.1995.0089Get rights and content

Abstract

The interaction between activated neutrophils and pulmonary endothelium is thought to contribute to the pathogenesis of the adult respiratory distress syndrome (ARDS), but its relation to ARDS severity, which may support a pathogenetic role, is unclear. Therefore, circulating inflammatory mediators, including the neutrophil chemoattractant and activator interleukin 8 (IL-8), the acute phase cytokine IL-6, and the neutrophil product elastase complexed to α1-antitrypsin ( α1-AT), were measured prospectively, together with gas exchange, ventilatory and radiographic variables, in 13 mechanically ventilated patients with ARDS, mostly owing to sepsis, at admission into the intensive care unit. Measurements were repeated in the eight improving patients at the time that positive end-expiratory pressure could be reduced to 0 cm H2O. From the gas exchange, ventilatory and radiographic abnormalities, a lung injury score (LIS) was calculated. For pooled data, the LIS and the arterial PO2/inspiratory O2fraction, the oxygenation ratio, correlated with plasma levels of IL-8 (rs=0.60,P<0.01 andrs= −0.65,P<0.005, respectively), with levels of IL-6 (rs=0.60,P<0.01, andrs=20.68,P<0.005, respectively), and the oxygenation ratio related to elastase- α1-AT (rs=20.70,P<0.005). Levels of IL-8 and IL-6 interrelated (rs=0.61,P<0.01) and related to the elastase complexes (rs=0.45,P<0.05). Hence, our datasupport a role of cytokine-induced activation of neutrophils in the clinical severity of ARDS.

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