[Soluble TNF p55 and p75 receptors in the development of sepsis syndrome]

The role is described of soluble type I p55 and type II p75 TNF receptors (sTNF-R) in the development of septic syndrome (SS). It is assumed, that at an early stage of infection, high levels of sTNF-R p55 and p75 augment systemic immunity and enhance the natural non-specific response. At the same time the presence of TNF-? in plasma proves inadequate secretion of sTNF-R p55 and p75 that is insufficient to block its generation and neutralization during SS. The concentration of sTNF-R p55 increases mainly at an early stage of infection, whereas p75 level rises constantly. High levels of p75 in the group of animals which survived may suggest that it is a more potent TNF-alpha cytotoxicity inactivator than the p55 form. This process occurs by means of blocking ligand bonds of TNF-alpha with its superficial effector cell receptor. These considerations lead to the conclusion that for the prognosis in septic syndrome, an incomparably greater role than absolute TNF-alpha concentration is played by the quantitative ratio of this cytokine to its soluble receptors. High values of TNF-alpha to sTNF-R ratio, especially to its p55 form, suggest loss of balance between the number of ligand bonds of cytokines and the activity of their inhibitors and usually come with poor prognosis and lack of efficient SS treatment. Soluble TNF receptors are physiological factors that inhibit TNF-alpha activity, the effect of which may be compared to that of monoclonal anti-TNF-alpha antibodies.