PLASMA-LEVELS OF THE CHEMOKINES MONOCYTE CHEMOTACTIC PROTEIN-1 AND PROTEIN-2 ARE ELEVATED IN HUMAN SEPSIS

Because of their effects on monocytes, monocyte chemotactic proteins-1 and -2 (MCP-1 and MCP-2) may participate in the pathophysiology of se psis. We measured circulating MCP-1 and MCP-2 levels in 42 septic pati ents having positive local or blood cultures. MCP-1 and MCP-2 levels w ere elevated in 24 (57%) and 25 (59%) of 42 septic patients, respectiv ely, compared with healthy volunteers. Both patients with gram-positiv e and gram-negative infections had elevated MCP-1 plasma levels (P = . 0001 and P < .0001, respectively; Mann Whitney-U test), whereas patien ts with gram-positive infection, but not those with gram-negative infe ction, had increased MCP-2 plasma levels (P = .0182). No relative diff erences in MCP-1 and MCP-2 plasma levels were observed between several subgroups of patients (sepsis v septic shock; survivors v nonsurvivor s), although levels of MCP-1 were the highest in patients with the mor e severe forms of sepsis, ie, those with shock or a lethal outcome. Se rial observations showed that MCP-1 and MCP-2 plasma levels remained e levated for at least 48 hours. MCP-1 correlated weakly with interleuki n-8 and MCP-2, the correlations for which were most pronounced in pati ents with septic shock. MCP-2 correlated with interleukin-8 and, surpr isingly, with the complement activation product C3a; these correlation s further improved when analyzing patients with septic shock or when a nalyzing gram-positive infections. Thus, our results not only show inc reased MCP-1 and MCP-2 levels in patients with sepsis, but also sugges t that the synthesis and release of MCP-1 and MCP-2 in sepsis are diff erently regulated in part. (C) by 1995 by The American Society of Hema tology.