Correlation between tumor necrosis factor-alpha and septic shock in children
Keywords:
TNF-a, sepsis, septic shock
Abstract
Background The crucial role cytokines play in the pathophysiologyof sepsis is widely accepted. Infection stimulates the production
of cytokines in various cell types. Tumor necrosis factor-alpha
(TNF-a) is one of the most extensively investigated cytokines in
experimental and clinical sepsis. Tumor necrosis factor-alpha has
been shown to mediate lethality in experimental sepsis.
Objective To evaluate for a possible correlation between TNF-a
level and septic shock in children.
Methods This cross-sectional study was conducted in Manado
from June to September 2011. A total of 40 patients with a
recent diagnosis of sepsis or septic shock were included. Plasma
specimens were collected from subjects for measurement of
TNF-a concentration. Logistic regression analysis was used to
assess the correlation between TNF-a level and sepsis, as well as
the probability of shock in children with sepsis, with P<0.05 as
statistically significant.
Results There was a strong positive correlation between
TNF-a level and the probability of shock in children with sepsis
(regression coefficient = 0. 78, P = 0.002).
Conclusions There is a strong positive correlation between
TNF-a level with the probability of shock in children with sepsis.
Higher plasma level ofTNF-a is associated with higher probability
of septic shock.
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inflammation. In: Khegman RM, Nelson EB, Jenson HB,
Stanton BF, editors. Nelson textbook of pediatrics. 18th ed.
Philadelphia: Elsevier Saunders; 2007. p. 1094-9.
2. Setiati TE. Penatalaksanaan syok septik pada anak. In:
Yunanto A, Sembiring M, Hartoyo E, Andayani P, editors.
Simposium nasional perinatologi & pediatri gawat darurat.
Banjarmasin: IDAI Kahmantan Selatan; 2005. p. 58-69.
3. Albiger B, Dahlberg S, Henriques BH, Normark S. Role of
the innate system in host defense against bacterial infections:
focus on the Toll-like receptors. J Intern Med. 2007;261:511-
28.
4. Goldstein B, Giroir B, Randolph A. International pediatrics
consensus conference: definitions for sepsis and organ
dysfunction in pediatrics. Pediatr Crit Care Med. 2005;
6:2-7.
5. Peters K, Unger RE, Brunner J, Kirkpatrick J. Molecular
basis of endothelial
6. Russel JA. Management of sepsis. N Eng J Med. 2006;
355:1699-712.
7. Remick DG. Pathophysiology of sepsis. Am J Pathol.
2007; 170:1435-44.
8. Pinsky MR. Pathophysiology of sepsis and multiple organ
failure: pro- versus anti-inflammatory aspects. In: Ronco C,
Bellomo R, BrendolanA, editors. Sepsis, kidney and multiple
organ dysfunction. Basel: Karger; 2004. p. 31-43.
9. Amersfoort ES, Berke! TJ, Kuiper J. Receptors, mediators, and
mechanisms involved in bacterial sepsis and septic shock.
Clin Microbial Rev. 2003;16:379-414.
10. Kocabas E, Sarickliogu A, Aksaray N, Seydaglu G, Seyhun
Y, Yaman A. Role of procalcitonin, C-reactive protein,
interleukin-6, interleukin-8 and tumor necrosis factor-a in
the diagnosis of neonatal sepsis. Turk J Pediatr. 2007;49:7-
20.
11. Bozza FA, SatluhJI, Japiassu AM, Marcio S, Assis EF, Gomes
RN, et al. Cytokine profiles as markers of disease severity in
sepsis: a multiplex analysis. Crit Care. 2007;11:1-8.
12. Goldstein B, Giroir B, Randolph A. International pediatric
sepsis consensus conference: definitions for sepsis and
organ dysfunction in paediatrics. Pediatr Crit Care Med.
2005 ;6: 2-8.
13. Runtunuwu AL, Manoppo JIC, Rampengan TH, Rampengan
NH, Kosim S. Efektivitas pemeriksaan prokalsitonin sebagai
petanda dini sepsis pada anak. Sari Pediatri. 2008;9:319-
22.
14. Watson RS, Carcillo JA, Linde-Zwirble WT, Clermont G,
Lidicker J, Angus DC. The epidemiology of severe sepsis in
children in the United States. Am J Respir Crit Care Med.
2003;167:695-701.
15. Proulx F, Fayon M, Farrel CA, Lacroix J, Gauthier M.
Epidemiology of sepsis and multiple organ dysfunction
syndrome in children. Chest. 1996; 109: 1033-7.
16. Hendra, Runtunuwu AL, Manoppo JIC. Pediatric logistic
organ dysfunction (PELOD) score as prognosis of multiple
organ failure in sepsis. Paediatr Indones. 2010;50:226-
31.
17. Kumar S, Rizvi M. Prognostic serum tumor necrosis factor-a
in paediatric patients with sepsis. J Infect Dev Ctries.
2009;3:437-41.
18. Abbas AK, Lichtman AH. Innate immunity: the early
defense against infection. In: Ab bas AK, Lichtman AH. Basic
immunology functions and disorders of the immune system.
yd ed. Philadelphia: Elsevier; 2009. p. 24-42.
19. Baratawidjaja KG. Sitokin. In: Baratawidjaja KG. Imunologi
dasar. 7th ed. Jakarta: Balai penerbit Fakultas Kedokteran UI;
2006. p. 119-38.
20. Oberholzer A, Souza SM, Tschoeke SK, Oberholzer C,
Abouhamze A, Pribble JP, et al. Plasma cytokine measurements
augment prognostic scores as indicators of outcome in patients
with severe sepsis. Shock. 2005;23:488-93.
21. Hep er Y, Akalin EH, Mistik R, Akgoz S, Tore 0, Goral G, et al.
Evaluation of serum C-reactive protein, procalcitonin, tumor
necrosis factor alpha, and interleukin -10 levels as diagnostic
and prognostic parameters in patients with community
acquired sepsis, severe sepsis and septic shock. Eur J Clin
Microbiol Infect Dis. 2006; 25 :481-91.
Published
2013-02-28
How to Cite
1.
Dinata K, Runtunuwu A, Mandei J, Lolombulan J. Correlation between tumor necrosis factor-alpha and septic shock in children. PI [Internet]. 28Feb.2013 [cited 24Nov.2024];53(1):1-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/237
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Received 2016-08-18
Accepted 2016-08-18
Published 2013-02-28
Accepted 2016-08-18
Published 2013-02-28
