TIME-COURSE OF CIRCULATING ACUTE-PHASE PROTEINS AND CYTOKINES IN SEPTIC PATIENTS

This study measured, using ELISA or bioassay methodology, fluctuation in concentration of the circulating cytokines tumor necrosis factor (T NF) and interleukin 6 (IL-6), and the acute phase proteins serum amylo id A (apoSAA) and C-reactive protein (CRP), in five septic patients, d uring a one-week period starting from the day of diagnosis. All had co nsistently detectable levels of circulating TNF (range of peak values, 0.6-13.6 ng/ml); two also had high IL-6 levels, while the remaining t hree had detectable levels only at some time points (range of peak val ues, 105-315 pg/ml). TNF concentrations fluctuated during the observat ion period, in some cases with a biphasic temporal pattern. TNF and IL -6 levels were undetectable (below 30 and 100 pg/ml respectively) in t he control population with our assays(1,2). ApoSAA concentrations in t hese patients (range of peak values, 65-975 mu g/ml) were correlated w ith TNF and with high CRP concentrations (range of peak values, 7-329 mu g/ml). ApoSAA concentrations ranged from 1 to 10 mu g/ml and CRP co ncentrations ranged from 0.6 to 1.9 mu g/ml in control populations wit h our assay. Statistically significant correlations between TNF levels and both apoSAA and CRP concentrations were observed for the five pat ients.