Inflammatory response of critically ill and haemodialysis patients after whole blood stimulation by cell wall components of Gram-positive bacteria and fungi

Introduction

The purpose of our study was to determine the acute inflammatory response of critically ill (ICU) and haemodialysis (HD) patients and to compare the cytokine profiles induced by different classes of pathogens in these two patient populations vulnerable to infections.

Methods

We studied production of IL-6 and TNFα in response to stimulation of whole blood with 1 μg lipoteichoic acid (LTA) and 1 μg mannan for 6 hours in ICU patients with various medical causes of admission and in HD patients just before dialysis.

Results

Blood samples were taken from 11 ICU patients (eight males; age 63.83 ± 10.73 years; APACHE II score 21.12 ± 3.45) and from nine HD patients (six males; age 65.11 ± 10.37 years). Results are presented in Table 1. Between the two patient groups, no differences were found concerning the intensity of the inflammatory response.

Table 1 Cytokine concentrations before and after LTA and mannan challenge

Conclusion

The basic concentration of IL-6 was higher in ICU patients. After ex vivo challenge with LTA and mannan, no differences in the intensity of the inflammatory response were detected between the two groups. LTA is a much more potent immunostimulator than mannan in both ICU and HD patients.