PLASMA INTERLEUKIN-1-ALPHA AND INTERLEUKIN-1-BETA, TUMOR-NECROSIS-FACTOR-ALPHA, AND LIPOPOLYSACCHARIDE CONCENTRATIONS DURING PULMONARY EXACERBATIONS OF CYSTIC-FIBROSIS

Earlier studies have reported the presence of interleukin-1 (IL-1) and tumor necrosis factor (TNF) in the plasma of patients with cystic fib rosis (CF), but the results have been inconsistent. To investigate the relationships among plasma IL-1 alpha, IL-1 beta, TNF, lipopolysaccha ride (LPS), and clinical status, measurements were made before and aft er 14 days of intravenous antibiotic therapy in 13 patients with CF. I n addition, whole blood cytokine production rates were measured in 18 hr cultures stimulated with 10 mu g/mL LPS or sterile saline (control) . On admission, patients with CF had significantly greater plasma leve ls of LPS and IL-1 alpha compared with 20 healthy adult controls. In r esponse to antibiotic therapy, the patients had statistically signific ant increases in weight, oxygen saturation, chest radiograph score, an d forced expiratory volume in 1 second. They had significant decreases in pulse rate, residual volume/total lung capacity ratio, white blood count, neutrophil count, LPS concentration, and resting energy expend iture per kg body weight. There were no significant changes in the pla sma concentrations of IL-1 alpha, IL-1 beta, or TNF and no significant changes in the basal or stimulated whole blood production rates of IL -1 alpha, IL-1 beta, or TNF. The immunological variables did not corre late significantly with clinical measurements of severity or the prese nce of fever. It is likely that in CF local pulmonary effects of cytok ines are of more pathophysiologic significance than systemic effects. 1994 Wiley-Liss, Inc.