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High macrophage migration inhibitory factor levels in disseminated intravascular coagulation patients with systemic

Satoshi Gando1, Atsushi Sawamura, Mineji Hayakawa

  • 1Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University School of Medicine, N15 W7, Kita-ku, Sapporo 060, Japan. gando@med.hokudai.ac.jp

Inflammation
|May 31, 2007
PubMed

Insights

Macrophage migration inhibitory factor (MIF) is linked to disseminated intravascular coagulation (DIC) in sepsis patients. Higher MIF levels correlate with organ dysfunction and poor prognosis in these critically ill individuals.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Immunology

Background:

  • Systemic inflammatory response syndrome (SIRS) and sepsis can lead to disseminated intravascular coagulation (DIC).
  • The role of macrophage migration inhibitory factor (MIF) in the pathogenesis of DIC within sepsis is not fully understood.
  • Understanding factors influencing DIC prognosis is crucial for patient outcomes.

Purpose of the Study:

  • To investigate the relationship between MIF and DIC in patients with SIRS/sepsis.
  • To assess the association of MIF and DIC with multiple organ dysfunction syndrome (MODS) and patient prognosis.
  • To explore the correlation between MIF, inflammatory markers, and coagulation parameters in DIC.

Main Methods:

  • Prospective cohort study of 48 patients with SIRS or sepsis.
  • Classification of patients into DIC (n=20) and non-DIC (n=28) groups.
  • Measurement of MIF, TNF-alpha, soluble fibrin, protein C, and PAI-1 on day 0 and days 1-4; assessment of SIRS criteria and DIC scores.

Main Results:

  • DIC patients exhibited significantly higher levels of MIF, TNF-alpha, soluble fibrin, and PAI-1 compared to non-DIC patients.
  • Protein C levels were significantly lower in DIC patients.
  • Peak MIF levels correlated with soluble fibrin in DIC patients (rs = 0.496, p < 0.0407).
  • All DIC patients developed MODS, with more organ dysfunction and poorer prognosis than non-DIC patients.
  • Peak MIF levels and DIC were significant predictors of mortality (OR 1.016 and 40.5, respectively).

Conclusions:

  • Elevated MIF and TNF-alpha levels are associated with increased organ dysfunction and poor prognosis in sepsis-related DIC.
  • MIF may play a significant role in the inflammatory and thrombotic processes underlying DIC in sepsis.
  • DIC is a critical factor associated with mortality in SIRS and sepsis patients.

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