PubMed Journals: Clin Chem
Source: PMID: 16195357
⇦ ⇨ Clin Chem. 2005 Dec;51(12):2333-40. Epub
⇩ 2005 Sep 29.
Early enhanced expression of interferon-inducible
protein-10 (CXCL-10) and other chemokines
predicts adverse outcome in
severe acute respiratory syndrome.
Tang NL(1), Chan PK, Wong CK, To KF, Wu
AK, Sung YM, Hui DS, Sung JJ, Lam CW.
(1) Department of Chemical Pathology, Faculty
of Medicine, The Chinese University of Hong Kong,
Exaggerated activation of cytokines/chemokines has
been proposed as a factor in adverse outcome of
severe acute respiratory syndrome (SARS). Previous
studies on chemokines have included only small
numbers of patients, and the utility of plasma
chemokines as prognostic indicators is unclear.
METHODS: We studied 255 archival plasma samples
collected during the first or second week after
disease onset. The chemokines interferon-inducible
protein-10 (IP-10), monokine induced by
interferon-gamma (MIG), interleukin-8 (IL-8),
monocyte chemoattractant protein-1 (MCP-1),
and regulated upon activation normal T cell
expressed and secreted (RANTES) were measured
by cytometric bead array with a 4-color
FACSCalibur flow cytometer. Reverse transcription
and real-time quantitative PCR and
immunohistochemical staining were performed
to analyze the production of IP-10 in lung
tissue at autopsy. Conditional logistic
regression was used to identify independent
predictors for adverse disease outcome.
RESULTS: Increases in IP-10, MIG, and IL-8
during the first week after onset of fever
were associated with adverse outcome (intensive
care unit admission or death) in the univariate
analysis. During the second week, only MIG
concentration was associated with prognosis.
After adjusting for other risk factors,
plasma IP-10 concentration at the first
week remained as an independent prognostic
factor, with an odds ratio for adverse outcome
of 1.52 (95% confidence interval, 1.05-2.55)
per fold increase in plasma IP-10 concentration
above the median. During the second week,
chemokines provided little independent prognostic
information. IP-10 was increased in lung tissue
from patients who died of SARS. CONCLUSIONS:
Increased plasma IP-10 during the first week of
SARS symptoms is an independent predictor of
outcome. Chemokine activation may be an early
event in SARS, and an exaggerated host
response may produce complications.
DOI: 10.1373/clinchem.2005.054460 PMID: 16195357
[Indexed for MEDLINE]