Predictive Value of Nuclear Factor kappa B Activity and Plasma Cytokine Levels in Patients with Sepsis

doi:10.1128/IAI.68.4.1942-1945.2000

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Infection and Immunity, April 2000, p. 1942-1945, Vol. 68, No. 4
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Predictive Value of Nuclear Factor $kappa$ B Activity and Plasma Cytokine Levels in Patients with Sepsis

Francisco Arnalich,¹^,^* Esther Garcia-Palomero,² Julia López,³ Manuel Jiménez,³ Rosario Madero,³ Jaime Renart,⁴ Juan José Vázquez,¹ and Carmen Montiel²

Departments of Medicine¹ and Pharmacology² and Intensive Care Unit,³ Hospital La Paz, Facultad de Medicina, Universidad Autónoma de Madrid, and Instituto de Investigaciones Biomédicas, CSIC,⁴ Madrid, Spain

Received 8 September 1999/Returned for modification 9 November 1999/Accepted 10 January 2000

The relationship between fluctuating cytokine concentrations in plasma and the outcome of sepsis is complex. We postulatedthat early measurement of the activation of nuclear factor $kappa$ B(NF- $kappa$ B), a transcriptional regulatory protein involved in proinflammatorycytokine expression, may help to predict the outcome of sepsis.We determined NF- $kappa$ B activation in peripheral blood mononuclearcells of 34 patients with severe sepsis (23 survivors and 11 nonsurvivors)and serial concentrations of inflammatory cytokines (interleukin-6,interleukin-1, and tumor necrosis factor) and various endogenousantagonists in plasma. NF- $kappa$ B activity was significantly higherin nonsurvivors and correlated strongly with the severity of illness(APACHE II score), although neither was related to the cytokinelevels. Apart from NF- $kappa$ B activity, the interleukin-1 receptorantagonist was the only cytokine tested whose level in plasmawas of value in predicting mortality by logistic regression analysis.These results underscore the prognostic value of early measurementof NF- $kappa$ B activity in patients with severesepsis.

^* Corresponding author. Mailing address: Servicio de Medicina Interna, Hospital Maternal La Paz, Planta 8, Paseo de la Castellana261, 28046 Madrid, Spain. Phone: 34-1-397-5353. Fax: 34-1-729-2280.E-mail: francisco.arnalich{at}uam.es.

Infection and Immunity, April 2000, p. 1942-1945, Vol. 68, No. 4
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

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Predictive Value of Nuclear Factor B Activity and Plasma Cytokine Levels in Patients with Sepsis

Predictive Value of Nuclear Factor $kappa$ B Activity and Plasma Cytokine Levels in Patients with Sepsis