Ja. Amado et al., BLOOD-LEVELS OF CYTOKINES IN BRAIN-DEAD PATIENTS - RELATIONSHIP WITH CIRCULATING HORMONES AND ACUTE-PHASE REACTANTS, Metabolism, clinical and experimental, 44(6), 1995, pp. 812-816
We hypothesized that increased levels of blood cytokines occur in brai
n dead patients, and that these cytokines are responsible for some of
the endocrine and/or acute-phase reactant abnormalities found in these
patients. We measured blood levels of cytokines, hormones, and acute-
phase reactants in 18 brain-dead potential organ donors at the moment
of establishing the legal diagnosis of brain death and compared them w
ith levels found in a control group. Although interleukin-1 beta (IL-1
beta) and tumor necrosis factor-alpha (TNF-alpha) levels were within
the normal range, interleukin-6 (IL-6) levels were clearly above the n
ormal range in all patients (median, 1,444 pg/mL; range, 75 to 11,780)
. In the brain-dead group, total thyroxine (tT(4)), free T-4 (fT(4)),
triiodothyronine (T-3), thyrotropin (TSH), dehydroepiandrosterone sulf
ate (DHEA S), testosterone, albumin, Zn, and osteocalcin levels were d
ecreased, T-3 resin uptake index (T-3 RUI), corticotropin (ACTH), cort
isol, 11-deoxycortisol (11-DOC), 17-hydroxyprogesterone (17-OHPr), ald
osterone, luteinizing hormone, and follicle-stimulating hormone levels
were normal, and reverse T-3 (rT(3)), renin, and C reactive protein (
CRP) levels were increased. Multiple regression analysis demonstrated
significant interrelations between IL-6 and T-4, T-3, testosterone, an
d CRP. We also studied the evolution of some of these parameters in fo
ur patients with severe head injury who finally developed brain death.
IL-6 levels on admission to the intensive care unit (ICU) were above
the normal limits, as in other patients with cranial trauma, but when
the patients developed brain death, there was a pronounced increase in
IL-6 levels. We conclude that brain death is accompanied by high leve
ls of IL-6. IL-6 may be partially responsible for the hormonal and acu
te-phase reactant abnormalities found in these patients. Copyright (C)
1995 by W.B. Saunders Company