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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 postulated that early measurement of the activation of nuclear factor kappa B (NF-kappa B), a transcriptional regulatory protein involved in proinflammatory cytokine expression, may help to predict the outcome of sepsis. We determined NF-kappa B activation in peripheral blood mononuclear cells 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 endogenous antagonists in plasma. NF-kappa B activity was significantly higher in nonsurvivors and correlated strongly with the severity of illness (APACHE II score), although neither was related to the cytokine levels. Apart from NF-kappa B activity, the interleukin-1 receptor antagonist was the only cytokine tested whose level in plasma was of value in predicting mortality by logistic regression analysis. These results underscore the prognostic value of early measurement of NF-kappa B activity in patients with severe sepsis.

* Corresponding author. Mailing address: Servicio de Medicina Interna, Hospital Maternal La Paz, Planta 8, Paseo de la Castellana 261, 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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