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Lack of correlation between soluble CD14 and IL-6 in meningococcal septic shock
E Arranz1, A Blanco-Quirós, P Solís
1Department of Pediatrics and Immunology, University of Valladolid, Spain.
Abstract:
Meningococcal sepsis is a good model to study the dynamic response of cytokines and other soluble factors in vivo in the early stages of the disease. Levels of soluble CD14, interleukin-6 (IL-6), IL-6 receptor (IL-6R), and C-reactive protein (CRP) have been measured in plasma from 26 children with septic shock (nine of whom had disseminated intravascular coagulation) and from ten control children. All samples were collected at the onset, before treatment, and, when possible, 24 and 48 hours later. At admission, patients had significantly higher levels of IL-6 (p < 0.001) and CRP (p < 0.001), and lower levels of IL-6R (p < 0.005) than normal controls. After 24 hours, there was a significant increase of sCD24 (p < 0.05) and CRP (p < 0.001). Although IL-6 showed a progressive decline since the onset, its levels were always higher than controls. There was an inverse correlation between IL-6 and both IL-6R (p < 0.001) and CRP (p < 0.001), probably due to the later increase of CRP. Nevertheless, sCD14 did not correlate with IL-6 levels. We have confirmed the finding of IL-6 as a sensitive and reliable inflammatory marker in septic shock. Moreover, the ratio IL-6/IL-6R may have a prognostic value, given a putative role of IL-6R in modulating the effects of IL-6 in meningococcal sepsis.
Insights
Meningococcal sepsis in children shows elevated inflammatory markers like interleukin-6 (IL-6) and C-reactive protein (CRP) at disease onset. The IL-6 to IL-6 receptor ratio may offer prognostic insights in severe cases.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Meningococcal sepsis serves as a model for studying early-stage inflammatory responses in vivo.
- Cytokines and soluble factors play crucial roles in the pathogenesis of severe infections.
Purpose of the Study:
- To investigate dynamic changes in soluble CD14, IL-6, IL-6 receptor (IL-6R), and CRP in children with meningococcal septic shock.
- To evaluate the potential of these markers, particularly the IL-6/IL-6R ratio, as indicators of disease severity and prognosis.
Main Methods:
- Plasma samples were collected from 26 children with septic shock and 10 controls at disease onset, and at 24 and 48 hours post-onset.
- Levels of soluble CD14, IL-6, IL-6R, and CRP were quantified using appropriate assays.
- Statistical analysis was performed to compare levels between groups and over time, and to assess correlations.
Main Results:
- Patients exhibited significantly higher IL-6 and CRP levels, and lower IL-6R levels at admission compared to controls.
- Soluble CD14 and CRP levels increased significantly within 24 hours.
- IL-6 levels decreased over time but remained elevated; an inverse correlation was observed between IL-6 and IL-6R, and IL-6 and CRP.
Conclusions:
- Interleukin-6 is a sensitive and reliable inflammatory marker in pediatric septic shock.
- The IL-6/IL-6R ratio may hold prognostic value in meningococcal sepsis, potentially related to IL-6R's role in modulating IL-6 effects.