Dissociation of LPS-induced monocytic ex vivo production of granulocyte colony-stimulating factor (G-CSF) and TNF-alpha in patients with septic shock

Over a 6 month period, in 192 patients admitted to the intensive care unit (ICU), a longitudinal analysis of whole blood lipopolysaccharide (LPS)-indu ced ex vivo cytokine production was performed on a daily basis until discha rge from the ICU or death, Twenty-one patients with proven infections were in septic shock for the first time and for at least 3 days' duration, Ex vi vo LPS-inducible release of granulocyte colony-stimulating factor (C-CSF) w as upregulated and that of TNF-alpha was downregulated in patients with sep tic shock, regardless whether they survived or died. In conclusion, LPS-ind uced ex vivo TNF-alpha and G-CSF cytokine release by monocytes is regulated differentially in patients with septic shock. Since upregulation of LPS-in duced production of G-CSF occurred earlier in survivors than in non-survivo rs, rapidly elevated and sustained C-CSF responsiveness may contribute to s urvival in septic shock. (C) 2001 Academic Press.