INTERLEUKIN-6 AND ITS SOLUBLE RECEPTOR DURING ACUTE MENINGOCOCCAL INFECTIONS - EFFECT OF PLASMA OR WHOLE-BLOOD EXCHANGE

Objectives: To determine the pattern of the soluble interleukin (IL)-6 receptor during acute meningococcal infections and recovery phase, an d to measure the effect of plasma or whole blood exchange on the plasm a concentrations of these mediators, Design: Prospective, descriptive patient study. Setting: University hospital intensive care unit. Patie nts: Patients with bacteriologically proven meningococcal infections w ere entered in the study, Three group were formed: a) patients with me ningitis without shock (group A); b) patients with meningitis and shoc k (group B); and c) patients with shock only (group C). Interventions: Part (n = 9) of the patients with shock underwent plasma or whole blo od exchange. Measurements and Main Results: Serum concentrations of in terleukin-6 and soluble IL-6 receptors were determined sequentially du ring the acute and recovery phases, Peak concentrations of IL-6 were h ighest in group C, followed by group B and group A. Soluble IL-6 recep tor concentrations showed an opposite pattern and were all below norma l, Soluble IL-6 receptor concentrations were negatively correlated wit h the IL-6 concentrations, During recovery, IL-6 rapidly decreased and soluble IL-6 receptors increased to supranormal concentrations, after which concentrations returned to normal, Plasma or whole blood exchan ge did not significantly influence IL-6 concentrations but did increas e the soluble IL-6 receptor concentration directly after an exchange s ession followed by a rapid decrease, Conclusions: Soluble IL-6 recepto r concentrations are low in acute meningococcal infections, Plasma or whole blood exchange temporarily increases these concentrations, It ne eds to be determined whether the effect of this therapy is beneficial to the patient.