Sepsis-induced acute respiratory distress syndrome with fatal outcome is associated to increased serum transforming growth factor beta-1 levels

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• 作者：Ra&uacute ; l de Pablo^a ; ^b ; ¹ ; ^{raul.depablo@uah.es} ; Jorge Monserrat^b ; ¹ ; Eduardo Reyes^b ; David D&iacute ; az^b ; Manuel Rodr&iacute ; guez-Zapata^b ; ^c ; Antonio de la Hera^b ; ^d ; Alfredo Prieto^b ; Melchor &Aacute ; lvarez-Mon^b ; ^c ; ^d ; ^e ; ^{mademons@gmail.com}
• 关键词：Acute Respiratory Distress Syndrome ; Cytokines ; Outcome ; Septic shock ; Transforming growth factor beta
• 刊名：European Journal of Internal Medicine
• 出版年：2012
• 期刊代码：91_09536205
• 类别：med
• 出版时间：June, 2012
• 卷：23
• 期：4
• 页码：358-362
• 文件大小：285 K

摘要

Background

TGF-尾1 is a promoter of pulmonary fibrosis in many chronic inflammatory diseases. TGF-尾1 circulating levels in patients with sepsis-induced Acute Respiratory Distress Syndrome (ARDS) have not been established.

Methods

In this prospective pilot cohort study, serum bioactive TGF-尾1 concentration, determined by sandwich ELISA, was analyzed in 52 patients who fulfilled criteria for septic shock at admission and on days 3 and 7.

Results

Of the 52 patients enrolled in the study, 46.1%fulfilled the criteria for ARDS on admission. At ICU admission, there were not statistical differences in TGF-尾1 concentrations between septic shock patients with or without ARDS. After 7 days of follow-up in ICU, circulating TGF-尾1 levels were significantly higher in patients with sepsis and ARDS than in those without ARDS [55.47 (35.04-79.48 pg/ml) versus 31.65 (22.89-45.63 pg/ml), respectively] (p = 0.002). Furthermore, in septic shock associated ARDS patients, TGF-尾1 levels were significantly higher in nonsurvivors than in survivors [85.23 (78.19-96.30 pg/ml) versus 36.41 (30.21-55.47 pg/ml), respectively] (p = 0.006) on day 7 of ICU follow-up.

Conclusions

In patients with septic shock, persistent ARDS is accompanied with increased circulating TGF-尾1 levels. Furthermore, ARDS patients with fatal outcome show higher TGF-尾1 concentrations than survivors. These results suggest the relevance of TGF-尾1 levels found in the pathogenesis of persistent sepsis-induced ARDS.