EE Douzinas, PD Tsidemiadou, MT Pitaridis, I Andrianakis, A Bobota-Chloraki, K Katsouyanni, D Sfyras, K Malagari and C Roussos
Critical Care Department, Athens University School of Medicine, Greece.

In order to explore whether an organ-specific pattern in cytokine and lactate concentrations exists in patients with multiple organ failure (MOF), we measured the cytokines interleukin-1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha (TNF-alpha), and lactate in blood taken from the hepatic vein, pulmonary capillaries, and peripheral veins of 10 patients with MOF with hepatic involvement (MOF-HI), eight patients with MOF and adult respiratory distress syndrome (MOF-ARDS), and five head-injured patients (controls). Ten additional patients participated in a study of arteriovenous pulmonary concentration gradients of these substances. For statistical analysis, nonparametric tests and analysis of variance (ANOVA) were used. The regional concentrations of these substances exhibited a different pattern in the two MOF groups. In the MOF-HI group, mean +/- SD cytokines IL-1beta and IL-6 (pg/ml) were respectively 216 +/- 100 and 461 +/- 343 in the hepatic sinusoidal blood; 149 +/- 52 and 293 +/- 204 in pulmonary capillary blood; and 148 +/- 105 and 234 +/- 162 in peripheral venous blood. In the MOF-ARDS group the corresponding levels were 180 +/- 103 and 235 +/- 124; 235 +/- 94 and 280 +/- 108; and 130 +/- 77 and 194 +/- 127. The TNF-alpha levels also exhibited the same pattern. The mean +/- SD corresponding levels (mmol/L) for lactate in the MOF-HI group were 3.1 +/- 1.8, 1.5 +/- 0.3, and 1.2 +/- 0.6, and in the MOF-ARDS group were 1.1 +/- 0.9, 1.8 +/- 1.1, and 1.0 +/- 0.2, respectively. The differences in the levels of all substances between the liver and lungs in the two MOF groups were statistically significant (p < 0.003). In the study of transpulmonary gradients it was shown that the levels of cytokine and lactate were lower in arterial blood than in mixed venous blood in MOF- HI patients, whereas the opposite was true in MOF-ARDS patients. In this study, we found that in MOF, cytokines and lactate are secreted from the most severely affected organs.

This article has been cited by other articles:

				E. Crimi, H. Zhang, R. N. N. Han, L. D. Sorbo, V.M. Ranieri, and A. S. Slutsky Ischemia and Reperfusion Increases Susceptibility to Ventilator-induced Lung Injury in Rats Am. J. Respir. Crit. Care Med., July 15, 2006; 174(2): 178 - 186. [Abstract] [Full Text] [PDF]

				J.-M. Cavaillon and D. Annane Invited review: Compartmentalization of the inflammatory response in sepsis and SIRS Innate Immunity, June 1, 2006; 12(3): 151 - 170. [Abstract] [PDF]

				A. M. Siore, R. E. Parker, A. A. Stecenko, C. Cuppels, M. McKean, B. W. Christman, R. Cruz-Gervis, and K. L. Brigham Endotoxin-induced acute lung injury requires interaction with the liver Am J Physiol Lung Cell Mol Physiol, November 1, 2005; 289(5): L769 - L776. [Abstract] [Full Text] [PDF]

				A. Ashare, L. S. Powers, N. S. Butler, K. C. Doerschug, M. M. Monick, and G. W. Hunninghake Anti-inflammatory response is associated with mortality and severity of infection in sepsis Am J Physiol Lung Cell Mol Physiol, April 1, 2005; 288(4): L633 - L640. [Abstract] [Full Text] [PDF]

				G. M. Matuschak, A. J. Lechner, Z. Chen, S. Todi, T. M. Doyle, and L. L. Loftis Hypoxic suppression of E. coli-induced NF-{kappa}B and AP-1 transactivation by oxyradical signaling Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2004; 287(2): R437 - R445. [Abstract] [Full Text] [PDF]

				S. Fernandez-Serrano, J. Dorca, M. Coromines, J. Carratala, F. Gudiol, and F. Manresa Molecular Inflammatory Responses Measured in Blood of Patients with Severe Community-Acquired Pneumonia Clin. Vaccine Immunol., September 1, 2003; 10(5): 813 - 820. [Abstract] [Full Text] [PDF]

				H. B. Suliman, M. S. Carraway, and C. A. Piantadosi Postlipopolysaccharide Oxidative Damage of Mitochondrial DNA Am. J. Respir. Crit. Care Med., February 15, 2003; 167(4): 570 - 579. [Abstract] [Full Text] [PDF]

				K. Doerschug, S. Sanlioglu, D. M. Flaherty, R. L. Wilson, T. Yarovinsky, M. M. Monick, J. F. Engelhardt, and G. W. Hunninghake First-Generation Adenovirus Vectors Shorten Survival Time in a Murine Model of Sepsis J. Immunol., December 1, 2002; 169(11): 6539 - 6545. [Abstract] [Full Text] [PDF]

				T. Ryan, J. Balding, E. M. McGovern, J. Hinchion, W. Livingstone, Z. Chughtai, and O. P. Smith Lactic acidosis after cardiac surgery is associated with polymorphisms in tumor necrosis factor and interleukin 10 genes Ann. Thorac. Surg., June 1, 2002; 73(6): 1905 - 1909. [Abstract] [Full Text] [PDF]

				G. M. MATUSCHAK, K. A. HENRY, C. A. JOHANNS, and A. J. LECHNER Liver-Lung Interactions Following Escherichia coli Bacteremic Sepsis and Secondary Hepatic Ischemia/Reperfusion Injury Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 1002 - 1009. [Abstract] [Full Text]

				L. L. Loftis, C. A. Johanns, A. J. Lechner, and G. M. Matuschak Brief hypoxic stress suppresses postbacteremic NF-kappa B activation and TNF-alpha bioactivity in perfused liver Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2000; 279(1): R99 - R108. [Abstract] [Full Text] [PDF]

				T. S. Walsh, S. McLellan, S. J. Mackenzie, and A. Lee Hyperlactatemia and Pulmonary Lactate Production in Patients With Fulminant Hepatic Failure Chest, August 1, 1999; 116(2): 471 - 476. [Abstract] [Full Text] [PDF]

				A. S. SLUTSKY and L. N. TREMBLAY Multiple System Organ Failure . Is Mechanical Ventilation a Contributing Factor? Am. J. Respir. Crit. Care Med., June 1, 1998; 157(6): 1721 - 1725. [Full Text] [PDF]

				D. DE BACKER, J. CRETEUR, H. ZHANG, M. NORRENBERG, and J.-L. VINCENT Lactate Production by the Lungs in Acute Lung Injury Am. J. Respir. Crit. Care Med., October 1, 1997; 156(4): 1099 - 1104. [Abstract] [Full Text] [PDF]

				G. M. MATUSCHAK, C. F. MUNOZ, C. A. JOHANNS, R. RAHMAN, and A. J. LECHNER Upregulation of Postbacteremic TNF-alpha and IL-1alpha Gene Expression by Alveolar Hypoxia/Reoxygenation in Perfused Rat Lungs Am. J. Respir. Crit. Care Med., February 1, 1997; 157(2): 629 - 637. [Abstract] [Full Text]