AI Article Synopsis

  • In a study of 39 patients with acute meningococcal infections, higher levels of tumor necrosis factor-alpha (TNF) and its receptors (TNFsR-p55 and TNFsR-p75) were found in patients experiencing shock compared to those who weren't.
  • Over the first 24 hours, shock patients showed an increased ratio of TNFsR-p75 to TNFsR-p55, indicating a unique response in their immune system.
  • Although TNF levels normalized after 12-24 hours, TNFsR levels remained elevated for 5-6 days, helping to distinguish between shock and non-shock patients; plasma exchange treatments did help lower TNFsR levels, but did not change their overall half-lives.

Article Abstract

In 39 patients with acute meningococcal infections, the plasma concentrations of tumor necrosis factor-alpha (TNF) and its soluble receptors (sRs) TNFsR-p55 and TNFsR-p75 were measured from admission till recovery. At admission, patients with shock had significantly higher TNF, TNFsR-p55, and TNFsR-p75 values than patients without shock. In addition, during the first 24 hours, patients with shock had higher TNFsR-p75 to TNFsR-p55 ratios, indicating that in shock the increase of TNFsR-p75 exceeds that of TNFsR-p55. TNF measured more than 12 hours after admission failed to differentiate between shock and nonshock because TNF concentrations normalized within 12-24 hours. However, because concentrations of TNFsRs remained elevated for 5-6 days, at that time plasma TNFsRs still differentiated between shock and nonshock. Plasma exchange or whole blood exchange (PEBE), performed in 20 patients with shock, accelerated the decrease of plasma TNFsRs. However, because of a rebound after each PEBE session, the overall half-lives of both TNFsRs were not affected by PEBE.

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http://dx.doi.org/10.1086/513933DOI Listing

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