Open AccessEnteric bacterial loads are associated with interleukin-6 levels in systemic inflammatory response syndrome patients
Author(s) -
Tzyy Bin Tsay,
Ming Yang,
Jen Tang Sun,
Pei Hsuan Chen,
Ying-Sheng Lin,
Meng Hung Shih,
Lee-Wei Chen
Publication year - 2016
Publication title -
formosan journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.135
H-Index - 8
eISSN - 2213-5413
pISSN - 1682-606X
DOI - 10.1016/j.fjs.2016.04.007
Subject(s) - systemic inflammatory response syndrome , medicine , systemic inflammation , enterocyte , inflammation , interleukin , immunology , gastroenterology , sepsis , cytokine , small intestine
BackgroundLoss of intestinal integrity is a critical contributor to excessive inflammation following severe trauma or major surgery. In the case of enterocyte damage, intestinal fatty acid-binding protein (IFABP) is released into the extracellular space. Excessive production of interleukin (IL)-6 can induce systemic inflammatory response syndrome (SIRS). However, the correlation of IL-6 with gut barrier failure and bacterial translocation in critically ill patients has not been well characterized.PurposesTo define the relationship between enteric bacterial loads and IL-6 levels in patients with SIRS.MethodsVariables related to prognosis and treatment were measured in 85 patients with SIRS upon admission to the emergency room. IL-6 and IFABP were measured using an enzyme-linked immunosorbent assay. Enteric bacterial loads in blood were measured through quantitative real-time polymerase chain reaction with primers specific for enteric bacteria.ResultsMultivariate analysis revealed a positive correlation between enteric bacterial loads and IL-6 levels in blood. Elevated IFABP concentration was associated with low blood pressure, high respiration rate, hyperglycemia, and high Sequential Organ Failure Assessment score. Elevated C-reactive protein concentrations were associated with higher soluble CD14 levels in blood.ConclusionEnterocyte damage is associated with hypotension and tachypnia in patients with SIRS. Gut function failure may permit enteric bacteria to enter the blood, thereby elevating IL-6 levels and inducing a systemic inflammatory response, resulting in multiple organ failure