Document Detail


Role of interleukin 6 in myocardial dysfunction of meningococcal septic shock.
MedLine Citation:
PMID:  14738793     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Myocardial failure has a central role in the complex pathophysiology of septic shock and contributes to organ failure and death. During the sepsis-induced inflammatory process, specific factors are released that depress myocardial contractile function. We aimed to identify these mediators of myocardial depression in meningococcal septic shock. METHODS: We combined gene-expression profiling with protein and cellular methods to identify a serum factor causing cardiac dysfunction in meningococcal septic shock. We identified genes that were significantly upregulated in blood after exposure to meningococci. We then selected for further analysis those genes whose protein products had properties of a myocardial depressant factor--specifically a 12-25 kDa heat-stable protein that is released into serum shortly after onset of meningococcal infection. FINDINGS: We identified 174 significantly upregulated genes in meningococcus-infected blood: six encoded proteins that were of the predicted size and had characteristics of a myocardial depressant factor. Of these, interleukin 6 caused significant myocardial depression in vitro. Removal of interleukin 6 from serum samples of patients with meningococcaemia and from supernatants of inflammatory cells stimulated by meningococci in vitro abolished the negative inotropic activity. Furthermore, concentrations in serum of interleukin 6 strongly predicted degree of myocardial dysfunction and severity of disease in children with meningococcal septic shock. INTERPRETATION: Interleukin 6 is a mediator of myocardial depression in meningococcal disease. This cytokine and its downstream mediators could be a target for future treatment strategies.
Authors:
Nazima Pathan; Cheryl A Hemingway; Ash A Alizadeh; Alick C Stephens; Jennifer C Boldrick; Emmanuelle E Oragui; Colm McCabe; Steven B Welch; Adeline Whitney; Peter O'Gara; Simon Nadel; David A Relman; Sian E Harding; Michael Levin
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  363     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-23     Completed Date:  2004-03-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatrics, Imperial College of Science, Technology and Medicine, W2 1PG, London, UK. n.pathan@imperial.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Cardiac Output, Low / blood,  physiopathology
Cardiomyopathies / blood,  physiopathology*
Cytokines / blood,  physiology
Humans
Interleukin-6 / blood,  physiology*
Male
Meningococcal Infections / blood,  physiopathology*
Myocardial Contraction / physiology
Myocardial Depressant Factor / blood,  physiology
Oligonucleotide Array Sequence Analysis
Rats
Rats, Sprague-Dawley
Shock, Septic / blood,  physiopathology*
Chemical
Reg. No./Substance:
0/Cytokines; 0/Interleukin-6; 0/Myocardial Depressant Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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