Abstract
Cytokines are endogenous inflammatory mediators, which play a central role in the pathophysiology of sepsis and in the expression of the adhesion molecules. The aims of this study are to analyze the levels of cytokines and the soluble adhesion in serum of infected (N = 68) and non-infected (N = 41) patients with systemic inflammatory response molecules (SIRS). 109 patients in the intensive care unit (ICU) of a tertiary hospital were included. IL-6, TNF-alpha, IL-10, IL-13, sICAM-1 and VCAM-1 were measured using enzyme-linked immunosorbent assay (ELISA). Patients with infectious SIRS, the levels of IL-6 varied between 27.65 to 39.6 pg/L(mean = 33.4 pg/L); the levels of sVCAM-1 varied between 543 and 1079 ng/ml (mean = 782 ng/ml) and the levels of sICAM-1 varied between 320 and 664 ng/ml (mean = 458 ng/ml). In patients with non-infectious SIRS the levels of IL-6 varied between 18.2 to 20.3 pg/L(mean 19.2 pg/L); the levels of sVCAM-1 varied between 251 and 635 ng/ml (mean = 286 ng/ml) and the levels of sICAM-1 varied between 98 and 351 ng/ml (mean = 168 ng/ml). The levels of IL-6, sVCAM-1 and s ICAM-1 were significantly higher in septic patients than in non-septic patients (p = 0.002; p = 0.003 and p = 0.0002, respectively). There was no statistically significant difference in the levels of TNF-alpha, IL-10 and IL-13 between infectious and non-infectious SIRS patients. Measurement of pro-and anti- inflammatory cytokines and soluble adhesion molecules may be useful in the follow up of ICU patients and in providing a point of care tests that will help in decision making and in management of ICU patients.