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Intensive Care Med. 2001 Jul;27(7):1187-93.

Macrophage migration inhibitory factor is a critical mediator of systemic inflammatory response syndrome.

Author information

1
Department of Anesthesiology and Critical Care Medicine, Hokkaido University School of Medicine, Sapporo, Japan. sgando@med.hokudai.ac.jp

Abstract

OBJECTIVE:

To determine the relations between macrophage migration inhibitory factor (MIF), tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), and cortisol in patients with systemic inflammatory response syndrome (SIRS) and to determine whether their levels correlate with patient survival.

DESIGN:

Prospective, observational, cohort study.

SETTING:

General intensive care unit in a university hospital.

PATIENTS AND PARTICIPANTS:

The study included 17 consecutive patients who met the criteria for SIRS; the patients were classified into subgroups, survivors (n = 8) and nonsurvivors (n = 9); eight healthy volunteers served as control subjects.

INTERVENTIONS:

None.

MEASUREMENTS AND RESULTS:

Serum MIF, TNF-alpha, IFN-gamma, and cortisol levels were measured serially when the patients were first identified as having SIRS (day 0), and on days 1-4. Except for the high tendency of acute respiratory distress syndrome in nonsurvivors (44%) compared to survivors (13%), there were no differences in the clinical backgrounds of the patients between the two groups. All patients had multiple organ dysfunction syndrome. The values of MIF and TNF-alpha in the nonsurvivors were significantly more elevated than those cytokines measured in the survivors and control subjects. Peak MIF levels significantly correlated with peak TNF-alpha levels (r2 = 0.448, P = 0.002), but did not correlate with peak levels of cortisol and IFN-gamma. Although the levels of IFN-gamma and cortisol showed a marked increase compared to those of the control subjects, we could not find differences in these variables between the survivors and the nonsurvivors.

CONCLUSIONS:

High MIF and TNF-alpha levels are closely linked with poor outcome in patients with SIRS. MIF and TNF-alpha may act together and have pathogenic roles in SIRS.

PMID:
11534567
DOI:
10.1007/s001340000818
[Indexed for MEDLINE]

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