Interleukin-8 and soluble intercellular adhesion molecule 1 during acute respiratory distress syndrome and in response to prolonged methylprednisolone treatment

Abstract

Aim. Interleukin-8 (IL-8) and intercellular adhesion molecule-1 (ICAM-1) promote migration and activation of neutrophils in the lung. We investigated the longitudinal relationship between circulating and bronchoalveolar lavage (BAL) levels of IL-8 and sICAM-1 during acute respiratory distress syndrome (ARDS) and in response to prolonged methylprednisolone (MP) treatment. Design. Prospective observational study, and prospective double-blind placebo controlled randomized study. Setting: University Medical Center. Methods. We studied 28 29 medical and surgical patients with ARDS. A reduction in lung injury score (LIS) > 1 point from day 1 to day 7 of ARDS divided patients into improvers (group 1, n=7) and nonimprovers (n=21). Nonim-provers included those (group 2, n=17) randomized to MP treatment vs placebo, and those who died prior to ARDS day 10 (group 3, n=4). All improvers survived. Interventions: We obtained serial measurements of plasma and BAL IL-8 and sICAM-1 levels, and components of the LIS. Results. At ARDS onset, improvers had lower IL-8 levels in the plasma and lower sICAM-1 levels in plasma and BAL. By ARDS day 10, plasma IL-8 remained persistently elevated in nonimprovers but declined in improvers (p<0.0001); whereas plasma sICAM-1 levels increased in nonimprovers (p<0.0001). BAL IL-8 levels correlated with BAL neutrophilia (r=0.56624, p= 0.02). MP treatment was associated with a reduction in IL-8 and sICAM-1 levels in plasma (by day 5, p<0.0001) and BAL (by days 8-15, p<0.0001). Conclusion. We provide additional evidence for the biological efficacy of MP treatment in unresolving ARDS.

Publication Title

Minerva Pneumologica

This document is currently not available here.

Share

COinS