Am. J. Respir. Crit. Care Med., Volume 163, Number 2, February 2001, 463-468

Anti-interleukin 8 Autoantibody:Interleukin 8 Complexes in the Acute Respiratory Distress Syndrome
Relationship between the Complexes and Clinical Disease Activity

ANNA KURDOWSKA, JAMES M. NOBLE, KENNETH P. STEINBERG, JOHN T. RUZINSKI, LEONARD D. HUDSON, and THOMAS R. MARTIN

University of Texas Health Center, Tyler, Texas; Section of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle; and Medical Research Service, Seattle VA Medical Center, Seattle, Washington

Increased levels of interleukin 8 (IL-8) are found in bronchoalveolar lavage (BAL) fluids from patients with the acute respiratory distress syndrome (ARDS). However, IL-8 is not an efficient predictor of the course of ARDS. Our prior studies demonstrated that IL-8 present in lung fluids from patients with ARDS is associated with anti-IL-8 autoantibodies (anti-IL-8:IL-8 complexes). These data led us to hypothesize that the complexes might better predict the development of acute lung injury. Accordingly, we measured concentrations of free and complexed IL-8 in BAL fluids from 19 patients at risk and 45 with established ARDS on Days 1, 3, 7, 14, and 21 after the onset of ARDS. The concentrations of anti-IL-8:IL-8 complexes in patients with ARDS on Day 1 were significantly higher than in patients at risk (p < 0.05). There was a significant association between anti-IL-8:IL-8 complex concentrations and the onset of ARDS (p = 0.03). Similarly, anti-IL-8:IL-8 complex concentrations were significantly higher in patients on Day 1 of ARDS who later died (p < 0.05), and the association between high anti-IL-8: IL-8 complex concentrations and the probability of dying was significant (p = 0.03). The presence of anti-IL-8:IL-8 complexes in BAL fluids of patients with ARDS is an important prognostic indicator for the development and outcome of ARDS.

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