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Neutrophil-Related Inflammatory Mediators in Septic Acute Respiratory Distress Syndrome

Department of Surgery, National Defense Medical College Research Institute, Saitama, Japan, manabu{at}res.ndmc.ac.jp

Satoshi Ono, MD, PhD

Department of Surgery, National Defense Medical College Research Institute, Saitama, Japan

Hidetaka Mochizuki, MD, PhD

Department of Surgery, National Defense Medical College Research Institute, Saitama, Japan

To disclose the participation of neutrophils in septic acute respiratory distress syndrome (ARDS), characteristics of various inflammatory mediators were examined in septic patients. Forty-seven gram-negative septic patients were divided into ARDS (n = 23) and non-ARDS (n = 24) groups at the transferred point to the intensive care unit. The mediators were measured simultaneously at the transferred point, and then subsequently on days 1, 3, and 5. At the transferred point, the ARDS group showed significantly higher levels of interleukin-8 (IL-8), macrophage inflammatory peptide-1-alpha (MIP-1-), soluble intercellular adhesion molecule-1 (sICAM-1), and neutrophil elas-tase despite lower neutrophil counts compared to the non-ARDS group. The ARDS group sustained significantly higher levels of sICAM-1 until day 5 and neutrophil elas-tase until day 1 compare to the non-ARDS group. Furthermore, nonsurviving ARDS patients (n = 8) showed significantly higher levels of tumor necrosis factor-alpha, IL-6, IL-8, and IL-10 compared to surviving ARDS patients (n = 15) at the transferred point. In conclusion, neutrophil-related inflammatory mediators, IL-8, MIP-1-, sICAM-1, and neutrophil elastase, appear to possibly participate in septic ARDS. Cytokines might also play an important role in the mortality of such cases.

Key Words: acute respiratory distress syndrome • sepsis • neutrophil • cytokine • adhesion molecule • neutrophil elastase

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