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Serum TNF‐Related and Weak Inducer of Apoptosis Levels in Septic Shock Patients
Author(s) -
Nagai Miho,
Hirayama Kouichi,
Ebihara Itaru,
Higuchi Takashi,
Imaizumi Masahiro,
Maruyama Hiroshi,
Miyamoto Yasunori,
Kakita Tomoko,
Ogawa Yujiro,
Fujita Shogo,
Shimohata Homare,
Kobayashi Masaki
Publication year - 2011
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2011.00966.x
Subject(s) - medicine , septic shock , hemoperfusion , sepsis , tumor necrosis factor alpha , microcirculation , vascular permeability , cytokine , immunology , polymyxin b , white blood cell , apoptosis , pathogenesis , inflammation , inducer , endocrinology , antibiotics , biology , hemodialysis , biochemistry , microbiology and biotechnology , gene
Capillary permeability is a tightly regulated feature of microcirculation in all organ beds. In sepsis, this feature is fundamentally altered. We have previously reported elevated levels of angiopoietin‐2 in patients with septic shock, and have investigated tumor necrosis factor (TNF)‐related and weak inducer of apoptosis (TWEAK), which mediates both angiogenesis and inflammation, in those patients. Enzyme‐linked immunoassay was used to measure serum TWEAK levels in 20 patients with septic shock, all of whom were treated by direct hemoperfusion with a polymyxin B‐immobilized fiber column (DHP‐PMX), and in 20 non‐septic controls. The TWEAK levels were higher in patients with septic shock (192.8 ± 230.5 pg/mL) than in controls (84.1 ± 28.7 pg/mL, P = 0.043). Between 11 survivors and 10 non‐survivors, there was no significant difference in the serum TWEAK levels before the DHP‐PMX therapy. During DHP‐PMX therapy, however, the serum TWEAK levels were significantly increased in non‐survivors (142.2 ± 88.1 pg/mL to 399.0 ± 307.1 pg/mL, P = 0.022). There was a significant correlation between the serum TWEAK levels and white blood cell counts ( r = 0.393, P < 0.001), platelet counts ( r = 0.418, P < 0.001), or serum CRP levels ( r = 0.259, P = 0.029), but there was no correlation between the serum TWEAK levels and blood pressure. The serum TWEAK levels were also correlated with the ratio of angiopoietin‐2 to ‐1 ( r = 0.464, P < 0.001). TWEAK may be a suitable marker of disease severity and mortality in septic patients, and TWEAK levels may be associated with vascular permeability via angiopoietin balance.