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Updated: Aug 22, 2026
Mesenchymal Stem Cell Regulation of Macrophage Phagocytosis; Quantitation and Imaging
Published on: July 16, 2021
Macrophage migration inhibitory factor levels correlate with fatal outcome in sepsis
Fernando A Bozza1, Rachel N Gomes, André M Japiassú
1ICU, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Abstract:
Macrophage migration inhibitory factor (MIF) is a cytokine playing a critical role in the pathophysiology of experimental sepsis. The purpose of this study was to determine the levels of MIF and to compare those to interleukin-6 (IL-6) levels in predicting mortality among critically ill patients with sepsis. The levels of MIF and IL-6 were measured in 25 patients with septic shock, 17 patients with sepsis, and 11 healthy volunteers. The median plasma concentrations of MIF and IL-6 were significantly higher in patients with septic shock and in patients with sepsis than in healthy controls. MIF levels were significantly different between survivors and nonsurvivors, as were IL-6 levels. Discriminatory power in predicting mortality, as assessed by the areas under receiver operating characteristic curves (AUROC), was 0.793 for MIF and 0.680 for IL-6. Finally, high plasma levels of MIF (> 1100 pg/mL) had a sensitivity of 100% and a specificity of 64% to identify the patients who eventually would evolve to a fatal outcome. Thus, our data suggest that an elevated MIF level in recently diagnosed septic patients appears to be an early indicator of poor outcome and a potential entry criterion for future studies with therapeutic intervention aiming at MIF neutralization.
Insights
Elevated macrophage migration inhibitory factor (MIF) levels in sepsis patients predict mortality. MIF shows higher predictive accuracy than interleukin-6 (IL-6) for fatal outcomes in critically ill sepsis patients.
Area of Science:
- Immunology
- Critical Care Medicine
- Biomarker Discovery
Background:
- Sepsis is a life-threatening condition with significant mortality.
- Macrophage migration inhibitory factor (MIF) is implicated in sepsis pathophysiology.
- Interleukin-6 (IL-6) is a known inflammatory marker in sepsis.
Purpose of the Study:
- To compare MIF and IL-6 levels in predicting mortality in critically ill sepsis patients.
- To assess the diagnostic accuracy of MIF and IL-6 for sepsis-related mortality.
- To identify MIF as a potential early indicator of poor prognosis in sepsis.
Main Methods:
- Plasma concentrations of MIF and IL-6 were measured in septic shock patients, sepsis patients, and healthy controls.
- Statistical analysis included comparing median concentrations and assessing discriminatory power using receiver operating characteristic curves (AUROC).
- Sensitivity and specificity of high MIF levels for predicting mortality were evaluated.
Main Results:
- MIF and IL-6 plasma levels were significantly elevated in sepsis and septic shock patients compared to controls.
- Both MIF and IL-6 levels differed significantly between survivors and non-survivors.
- MIF demonstrated a higher AUROC (0.793) than IL-6 (0.680) for mortality prediction.
- High MIF levels (> 1100 pg/mL) showed 100% sensitivity and 64% specificity for fatal outcomes.
Conclusions:
- Elevated plasma MIF is a significant early indicator of poor outcome in sepsis patients.
- MIF exhibits superior predictive value for mortality compared to IL-6 in critical sepsis.
- MIF represents a potential therapeutic target and entry criterion for future sepsis intervention studies.