CIRCULATING LEUKEMIA INHIBITORY FACTOR LEVELS CORRELATE WITH DISEASE SEVERITY IN MENINGOCOCCEMIA

Circulating concentrations of the proinflammatory cytokine leukemia in hibitory factor (LIF) were prospectively determined by radioreceptor c ompetition assay (sensitivity, 1 ng/mL) in 33 subjects with meningococ cemia. LIF was detected in the plasma of 13 subjects and was associate d with development of septic shock (P < .01), disseminated intravascul ar coagulation (P < .05), multiorgan failure (P < .05), and death (P < .01). Plasma LIF concentrations were highest (1-1772 ng/mL) at hospit al admission and became undetectable within 36 h, and the peak levels correlated inversely with systolic blood pressure (r, - .70, P < .001) , peripheral blood leukocyte count (r, - .58, P < .01), and prodromal interval (r, - .60, P < .001). Plasma LIF concentrations >400 ng/mL we re present only in subjects with fatal fulminant infection. LIF concen trations in plasma collected within 12 h of hospital admission correla ted with disease severity in patients with meningococcemia. It is like ly that LIF participates in the host response to infection, and it may contribute to the pathogenesis of septic shock.