IL-6 as a marker of excessive TNF-α activity in sepsis

Edward A Panacek, Martin Kaul

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The proinflammatory response triggered by infection and injury is initially protective and mediated by a number of host factors including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-8. In excess, these factors may cause severe tissue damage and life-threatening physiologic perturbations. If patients with a hyperinflammatory response can be identified early, they may benefit from treatment aimed at attenuating this response. In experimental models of sepsis, proinflammatory cytokines appear in the circulation in a relatively ordered manner but clinical sepsis is not as predictable. Compromised response mechanisms, interfering physiologic disturbances and therapeutic agents, and a variable temporal relationship to the onset of infection probably all contribute to the wide variability in both frequency and magnitude of their appearance seen in different studies. Although TNF-α is a proximal mediator of sepsis, circulating TNF-α concentrations at the time of diagnosis do not consistently correlate with disease severity. IL-6 is induced by TNF, appears in the circulation after the initial TNF response, often remains elevated, and is more consistently measurable. These properties may make it a good surrogate measure of localized TNF-α activity. In numerous studies, IL-6 was consistently shown to be elevated in septic patients, and serum concentrations correlated well with measures of disease severity and mortality. Assessing circulating IL-6 at the time of sepsis diagnosis may enable treatment decisions that are more directed to the individual patient's inflammatory response.

Original languageEnglish (US)
Pages (from-to)65-73
Number of pages9
JournalSepsis
Volume3
Issue number1
DOIs
StatePublished - 1999

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Interleukin-6
Sepsis
Tumor Necrosis Factor-alpha
Infection
Interleukin-8
Interleukin-1
Theoretical Models
Therapeutics
Cytokines
Mortality
Wounds and Injuries
Serum

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Microbiology (medical)

Cite this

IL-6 as a marker of excessive TNF-α activity in sepsis. / Panacek, Edward A; Kaul, Martin.

In: Sepsis, Vol. 3, No. 1, 1999, p. 65-73.

Research output: Contribution to journalArticle

Panacek, Edward A ; Kaul, Martin. / IL-6 as a marker of excessive TNF-α activity in sepsis. In: Sepsis. 1999 ; Vol. 3, No. 1. pp. 65-73.
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