OBJECTIVETo explore the significance of interleukin-6 (IL-6) and IL-8 in the diagnosis of neonatal sepsis.

METHODSThis was a prospective study conducted between August 2014 and February 2015. A total of 140 neonates who were suspected infectious were enrolled and classified into a sepsis group (n=49) and a local infection group (n=91). Sixty-one neonates who were non-infectious served as the control group. Serum levels of IL-6 and IL-8 were measured before treatment and 3 days after treatment. The value of serum IL-6 and IL-8 for the diagnosis of neonatal sepsis was assessed by receiver operating characteristic (ROC) curve analysis.

RESULTSBefore treatment, serum levels of IL-6 and IL-8 in the sepsis group were higher than those in the local infection and control groups (P<0.05), and the local infection group had higher serum levels of IL-6 and IL-8 than the control group (P<0.05). After three days of treatment, the serum IL-6 level in the sepsis group remained higher than that in the local infection and control groups (P<0.05), and the local infection group had higher serum level of IL-6 than the control group (P<0.05). There was no significant difference in the serum IL-8 level among the three groups. According to the ROC curve, when the cut-off value of serum IL-6 was 32 pg/mL, the sensitivity, specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 87.8%, 79.6% and 81.6% respectively; when the cut-off value of serum IL-8 was 54 pg/mL, the sensitivity, specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 77.6%, 63.8% and 67.2% respectively. With the combination of serum IL-6 and IL-8 levels, the sensitivity, specificity and accuracy for the diagnosis of neonatal sepsis were 71.4%, 86.2% and 82.6% respectively.

CONCLUSIONSIL-6 and IL-8 participate in the inflammatory response and the serum levels of both vary with the severity of infection. The diagnostic value of IL-6 for neonatal sepsis is higher than IL-8. The combined detection of serum levels IL-6 and IL-8 may increase the accuracy of diagnosis of neonatal sepsis.

C-Reactive Protein ; analysis ; Female ; Humans ; Infant, Newborn ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; ROC Curve ; Sepsis ; blood ; diagnosis

BACKGROUND: Disseminated intravascular coagulation (DIC) is a syndrome characterized by a systemic activation of coagulation leading to the intravascular deposition of fibrin and the simultaneous consumption of coagulation factors and platelets. Inflammatory cytokines can activate the coagulation system. This study investigated the diagnostic and prognostic usefulness of the plasma level of interleukin-6 (IL-6) and interleukin-10 (IL-10) for predicting DIC. METHODS: The study populations were 15 healthy controls and 81 patients who were clinically suspected of having DIC and were requested to perform DIC battery tests. The presence of overt DIC was defined by the International Society on Thrombosis and Haemostasis Subcommittee cumulative score of 5 or above. The 28 day mortality was used to assess the prognostic outcome. The plasma levels of the cytokines were measured by ELISA. RESULTS: The plasma levels of IL-6 and IL-10 in patients (N=81) were higher than those of control (N=15). IL-6 and IL-10 levels of overt DIC group (N=31) were 3 times and 1.5 times higher than those, respectively, of non-overt DIC group (N=50). In infection group (N=48), IL-6 and IL-10 levels of overt DIC group (N=18) were 5 times and 3 times higher than those, respectively, of non-overt DIC group (N=30). The diagnostic efficiency of IL-6 (optimal cut off >40.4 pg/mL) and IL-10 (>9.7 pg/mL) for the diagnosis of overt DIC were 67% and 69%, respectively, which were similar to that of D-dimer. Plasma levels of IL-6 and IL-10 were also higher in non-survivors than in survivors. The patients with higher levels of IL-6 and IL-10 showed a poorer prognosis. CONCLUSIONS: The proinflammatory cytokine, IL-6 and anti-inflammatory cytokine, IL-10 were useful for the diagnosis of overt DIC and the prediction of its prognosis. These results also showed the evidence of a close interaction between coagulation and inflammation.
Adult ; Aged ; Blood Coagulation Tests ; Disseminated Intravascular Coagulation/blood/*diagnosis/mortality ; Female ; Humans ; Infection/blood ; Interleukin-10/*blood ; Interleukin-6/*blood ; Male ; Middle Aged ; Prognosis ; Survival Analysis

OBJECTIVETo observe the effects of blood purification in the treatment of burn sepsis, in order to provide evidence for its application.

METHODSTwenty-seven patients with burn sepsis admitted to our burn ward from June 2012 to December 2013, conforming to the study criteria, were divided into conventional treatment group (CT, n = 15) and blood purification group (BP, n = 12) according to the random number table. After the diagnosis of sepsis was confirmed, patients in group CT received CT, while patients in group BP received both CT and continuous veno-venous hemodiafiltration for 48 hours. At the time of diagnosis of sepsis (before treatment) and post treatment hour (PTH) 24 and 48, levels of blood lactate and PaO2 were analyzed with blood gas analyzer, and the oxygenation index (OI) was calculated; blood sodium, blood glucose, blood urea nitrogen (BUN), creatinine, white blood cell count (WBC), procalcitonin (PCT) were determined; acute physiology and chronic health evaluation (APACHE) II score was estimated basing on the body temperature, respiratory rate, mean arterial pressure, PaO2, and blood pH values. The levels of TNF-α, IL-8, and IL-6 in serum were determined by ELISA. Data were processed with Fisher's exact test, t test, analysis of variance for repeated measurement, LSD- t test, and LSD test.

RESULTS(1) The levels of blood lactate of patients in group BP were significantly lower than those of group CT at PTH 24 and 48 (with t values respectively 1.62 and 2.44, P values below 0.05). Compared with that detected before treatment, the level of blood lactate in group BP was significantly decreased at PTH 48 (P < 0.05). The OI values of patients in group BP at PTH 24 and 48 [(247 ± 30), (288 ± 41) mmHg, 1 mmHg = 0.133 kPa] were significantly higher than those of group CT [(211 ± 32), (212 ± 30) mmHg, with t values respectively 3.02 and 5.63, P values below 0.01]. Compared with that detected before treatment, the OI values of patients in group BP at PTH 24 and 48 were significantly higher (P values below 0.01). (2) Compared with those of group CT at PTH 24 and 48, the levels of blood sodium, BUN, and creatinine were significantly lower (with t values from 1.74 to 6.75, P < 0.05 or P < 0.01), while the level of blood glucose was approximately the same (with t values respectively -0.92, -0.38, P values above 0.05) in group BP. Compared with those detected before treatment, the levels of blood sodium, BUN, and creatinine of group BP at PTH 24 and 48 were significantly lower (P < 0.05 or P < 0.01). (3) The levels of WBC and PCT of patients in group BP at PTH 24 and 48 were significantly lower than those of group CT (with t values from 2.11 to 6.63, P < 0.05 or P < 0.01). Compared with those detected before treatment, the levels of WBC and PCT of patients in group BP at PTH 24 and 48 were significantly lower (P < 0.05 or P < 0.01). (4) The APACHE II scores of patients in group BP at PTH 24 and 48 [(18.7 ± 2.6) and (16.7 ± 3.0) scores] were significantly lower than those of group CT [(23.1 ± 1.6) and (25.5 ± 1.6) scores, with t values respectively 5.44 and 9.87, P values below 0.01]. Compared with those calculated before treatment, the APACHE II scores of patients in group CT were significantly increased (P < 0.05 or P < 0.01), while those in group BP were decreased at PTH 24 and 48 (P < 0.05 or P < 0.01). (5) The levels of TNF-α, IL-6, and IL-8 in serum of patients in group BP at PTH 24 and 48 were significantly lower than those of group CT (with t values from 6.12 to 19.78, P values below 0.01). Compared with those detected before treatment, the levels of TNF-α, IL-6, and IL-8 in serum of group BP at PTH 24 and 48 were significantly decreased (with P values below 0.01).

CONCLUSIONSBP+CT is effective in improving organ function, correcting the disorder of internal environment, and controlling inflammation. Therefore, BP is an important method in the treatment of burn sepsis.

Aged ; Animals ; Blood Gas Analysis ; methods ; Burns ; blood ; complications ; Humans ; Interleukin-6 ; blood ; Interleukin-8 ; Sepsis ; diagnosis ; etiology ; therapy ; Serum ; metabolism ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo investigate the association of serum concentration of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) with insulin resistance in women with gestational diabetes mellitus (GDM).

METHODSForty normal pregnant women (NGT group) and 23 women with GDM (GDM group) were enrolled in this study with another 25 women of child-bearing age as the control group. Radio immunoassay (RIA) was used to measure the fasting serum IL-6 levels, and immunoturbidimetry performed to evaluate serum hs-CRP levels. The homeostasis model assessment-insulin resistance (HOMA-IR) and the homeostasis model assessment-B (HOMA-B) were calculated.

RESULTSCompared with NGT group and control group, GDM group had significantly elevated serum IL-6 and hs-CRP (P<0.01), but the levels were comparable between the former two groups (P>0.05). HOMA-IR was the highest in GDM group (P<0.001), and NGT group had significantly higher HOMA-IR than the control group (P<0.05), whereas the reverse was true for HOMA-B (P<0.01). Pearson correlation analysis showed that fasting blood glucose (FBG), fasting insulin (FINS), IL-6 and hs-CRP had significant association with HOMA-IR (P<0.01). Multiple regression analysis identified FINS, FBG, IL-6, and hs-CRP as the factors significantly affecting HOMA-IR (regression coefficient of 0.563, 0.992, 0.325, and 0.231, respectively, P<0.01).

CONCLUSIONSSerum levels of IL-6 and hs-CRP are elevated in women with GDM, which are the most significant factors affecting HOMA-IR. IL-6 and CRP may aggravate insulin resistance through various mechanisms and participate in the pathogenesis of GDM.

Adult ; Blood Glucose ; analysis ; C-Reactive Protein ; analysis ; Diabetes, Gestational ; blood ; Fasting ; blood ; Female ; Humans ; Insulin ; blood ; Insulin Resistance ; Interleukin-6 ; blood ; Pregnancy ; Radioimmunoassay

OBJECTIVEImmunovasculitis is a pathologic process of Kawasaki disease (KD) in the early stage and it is more likely to result from abnormal immunoactivation. It is thus speculated that the serum levels of some cytokines have changed before immunovasculitis occurs, suggesting the cytokines may be useful markers for the early diagnosis of KD. In this study, we measured the serum levels of soluble interleukin-2 receptors (sIL-2R), interleukin-6(IL-6) and high-sensitive C-reactive protein (hs-CRP) in patients with KD to evaluate the significance of these cytokines in the early diagnosis of KD.

METHODSSerum levels of sIL-2R and IL-6 were measured by rapid one-step sandwich enzyme immunoassay and the serum hs-CRP level was measured by Dade Behring BN ProSpec in 32 KD patients before and after intravenous immunoglobulin (IVIG) therapy. Twenty healthy children were used as the controls.

RESULTSBefore IVIG therapy serum levels of sIL-2R (9253.41 +/- 2568.38 pg/mL vs 2161.53 +/- 696.92 pg/mL; P < 0.05), IL-6 (57.19 +/- 45.78 ng/mL vs 7.04 +/- 1.69 ng/mL; P < 0.05) and hs-CRP (117.69 +/- 42.05 mg/L vs 1.15 +/- 0.54 mg/L; P < 0.05) in KD patients were significantly higher than those in healthy controls. After IVIG therapy in KD patients serum IL-6 levels returned to normal and sIL-2R and hs-CRP levels decreased significantly but remained significantly higher than controls (P < 0.05). There was a positive correlation between sIL-2R and hs-CRP levels (r=0.60, P < 0.01). IL-6 levels positively correlated with hs-CRP levels in KD patients before IVIG therapy (r=0.68, P < 0.01).

CONCLUSIONSIL-2R, IL-6 and hs-CRP are activated in the development of KD, and they may be of important value in the early diagnosis of KD.

C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant ; Interleukin-6 ; blood ; Male ; Mucocutaneous Lymph Node Syndrome ; blood ; therapy ; Receptors, Interleukin-2 ; blood

Kawasaki disease (KD) is an acute febrile illness of infancy and early childhood. In spite of extensive studies, the cause of KD is not known. Interleukin 6 (IL-6) has manyfold biological functions involved in the immune or inflammatory responses of the host to various stimuli. Here the author investigated whether IL-6 might be responsible for manifestations of KD, such as immunoglobulin hypersecretion, lymphocyte activation and systemic vasculitis. Serum IL-6 levels in KD were determined by ELISA. Usually sera from healthy children contained only negligible levels of IL-6. Serum IL-6 was markedly elevated in all patients with acute KD, which gradually decreased during the course of the disease. Serum IL-6 correlated with serum concentration of C-reactive protein and with serum soluble interleukin-2 receptor level, but did not show any correlation with peak platelet count during subacute phase of the disease. Increased serum IL-6 level did not show any relation to development of coronary aneurysms and dilatation. Further studies will be needed to examine the source and the pathogenetic roles of increased serum IL-6 in KD.
Child ; Child, Preschool ; Female ; Human ; Infant ; Interleukin-6/*blood ; Male ; Mucocutaneous Lymph Node Syndrome/*blood ; Receptors, Interleukin-2/analysis ; Thrombocytosis/etiology

OBJECTIVETo probe into the mechanisms of moxibustion and Chinese herbs in delaying aging.

METHODSSixty SD rats were randomly divided into a young control group, an aging group, a moxibustion group, a Chinese herb group and a moxibustion plus Chinese herb group. In the latter 4 groups, aging rat model was established by hypodermic injection of D-galactose. In the course of modeling, the 3 treatment group were treated by mild-warm moxibustion at "Zusanli (ST 36)", "Shenshu (BL 23)" and "Guanyuan (CV 4)" with reinforcing method, stomach perfusion of decoction of Liuwei Dihuang plus Danggui (Angelica) and Danshen (Salvia Miltiorrhiza Bge), and the moxibustion plus the Chinese herbs, respectively. After treatment for 40 days, liver mitochondrial DNA, serum IL-2 and IL-6 contents were detected.

RESULTS(1) The mitochondrial DNA content of liver cells and serum IL-6 level significantly increased (P < 0.05, P < 0.01) and serum IL-2 level significantly decreased (P < 0.05) in the aging model group as compared with those in the young control group. (2) The mitochondrial DNA content of liver cells and serum IL-6 level significantly decreased (P < 0.05, P < 0.01) and serum IL-2 level significantly increased (P < 0.05) in all the treatment group as compared with those in the aging model group.

CONCLUSIONMoxibustion and Chinese herbs function delaying aging though decreasing mitochondrial DNA content of liver cells and serum IL-6 level and increasing serum IL-2 level.

Aging ; drug effects ; immunology ; Animals ; DNA, Mitochondrial ; analysis ; Drugs, Chinese Herbal ; pharmacology ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Medicine, Chinese Traditional ; Moxibustion ; Rats ; Rats, Sprague-Dawley

Blood Cell Count ; Bone Marrow Cells ; pathology ; Child ; Cytokines ; analysis ; Fever ; Histiocytosis, Non-Langerhans-Cell ; metabolism ; pathology ; therapy ; Humans ; Interleukin-2 ; analysis ; Interleukin-6 ; analysis ; Receptors, Interleukin-1 ; analysis

OBJECTIVETo observe the changes in plasma levels of lipopolysaccharide (LPS), tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) in burn patients with severe infection treated with Imipenem or Cefoperazone.

METHODSThirteen severe burn patients infected with gram negative bacilli were enrolled in the study in which 7 were treated with IPM and 6 with CPZ. Venous blood samples were harvested before and 2, 12, 24, 48 and 72 hours after the use of antibiotic for the determination of the plasma levels of LPS, TNF-alpha and IL-6, and correlative analysis was carried out among all the factors in regard to their changes.

RESULTSThe plasma levels of LPS in both groups were elevated 2 hours after the injection of either antibiotic, but it was more obvious in patients with CPZ when compared with that before treatment (13.95 +/- 5.44 pg/ml), and the levels were much higher than that after IPM (P < 0.05). The plasma LPS level declined thereafter. The plasma TNF-alpha level in CPZ group was 0.86 +/- 0.16 ng/ml at 2 hours after the use of antibiotic, and it was much higher than that before the use of the drug, and it was higher compared with IPM group. (P < 0.01). But there was no change in the plasma IL-6 level in all the patients at all the time points before and after the use of either drug. The plasma TNF-alpha levels in the two groups were positively correlated with the plasma levels of LPS and IL-6.

CONCLUSIONThe release of LPS and TNF-alpha from bacteria could be induced by the administration of different kinds of antibiotics in the management of burn patients infected by gram negative bacilli in different releasing amounts. And the TNF-alpha production was correlated with the release of LPS and IL-6.

Burns ; blood ; Cefoperazone ; therapeutic use ; Female ; Gram-Negative Bacterial Infections ; blood ; drug therapy ; Humans ; Imipenem ; therapeutic use ; Interleukin-6 ; blood ; Lipopolysaccharides ; blood ; Male ; Tumor Necrosis Factor-alpha ; analysis

Adolescent ; CD3 Complex ; blood ; CD4 Antigens ; blood ; CD8 Antigens ; blood ; Child ; Fetal Blood ; immunology ; Humans ; Infant, Newborn ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; Nitric Oxide ; blood ; T-Lymphocytes ; immunology ; Tumor Necrosis Factor-alpha ; analysis