INTERLEUKIN-1 (IL-1) RECEPTOR ANTAGONIST PREVENTS STAPHYLOCOCCUS-EPIDERMIDIS-INDUCED HYPOTENSION AND REDUCES CIRCULATING LEVELS OF TUMOR-NECROSIS-FACTOR AND IL-1-BETA IN RABBITS

Similar to shock in gram-negative sepsis, shock from gram-positive org anisms is mediated, in part, by tumor necrosis factor (TNF) and interl eukin-I (IL-1). In the present study, rabbits were infused with IL-1 r eceptor antagonist (IL-1ra) prior to and during Staphylococcus epiderm idis-induced hypotension. After injection of bacteria, a maximal fall in mean arterial pressure to -42% below baseline occurred at 200 min i n vehicle-treated animals compared with a nonsignificant decrease of o nly 7% in the IL-1ra-treated group (P < 0.01, vehicle versus IL-1ra). A similar attenuation was observed in the fall in systemic vascular re sistance (P < 0.05). After the injection of S. epidermidis, TNF levels rose to a peak elevation of 475 +/- 160 U/ml in vehicle-treated rabbi ts, but in rabbits receiving IL-1ra, maximal TNF levels rose only to 8 5 +/- 23 U/ml (P < 0.01). Plasma IL-1beta reached maximal concentratio ns at 180 min of 364 +/- 71 pg/ml in vehicle-treated animals but only 145 +/- 12 pg/ml in rabbits given IL-1ra (P < 0.05). The reductions in TNF and IL-1 were not due to interference by IL-1ra in the respective assays. In vitro, IL-1ra inhibited S. epidermidis-induced TNF from mo nonuclear cells by 31% +/- 11%, from spleen cells by 17% +/- 4% (P < 0 .05), and from whole blood by 42% +/- 17%. Despite the near reversal o f the fall in mean arterial pressure and systemic vascular resistance in IL-1ra-treated rabbits, leukopenia and thrombocytopenia were unaffe cted. These results demonstrate that IL-1ra blocks shock-like hemodyna mic parameters and reduces circulating IL-1 and TNF levels in a model of gram-positive sepsis.