Interleukin 8-related neutrophil elastase and the severity of the adult respiratory distress syndrome

A B Groeneveld, P G Raijmakers, C E Hack, L G Thijs

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The interaction between activated neutrophils and pulmonary endothelium is thought to contribute to the pathogenesis of the adult respiratory distress syndrome (ARDS), but its relation to ARDS severity, which may support a pathogenetic role, is unclear. Therefore, circulating inflammatory mediators, including the neutrophil chemoattractant and activator interleukin 8 (IL-8), the acute phase cytokine IL-6, and the neutrophil product elastase complexed to alpha 1-antitrypsin (alpha 1-AT), were measured prospectively, together with gas exchange, ventilatory and radiographic variables, in 13 mechanically ventilated patients with ARDS, mostly owing to sepsis, at admission into the intensive care unit. Measurements were repeated in the eight improving patients at the time that positive end-expiratory pressure could be reduced to 0 cm H2O. From the gas exchange, ventilatory and radiographic abnormalities, a lung injury score (LIS) was calculated. For pooled data, the LIS and the arterial PO2/inspiratory O2 fraction, the oxygenation ratio, correlated with plasma levels of IL-8 (rs = 0.60, P < 0.01 and rs = -0.65, P < 0.005, respectively), with levels of IL-6 (rs = 0.60, P < 0.01, and rs = -0.68, P < 0.005, respectively), and the oxygenation ratio related to elastase-alpha 1-AT (rs = -0.70, P < 0.005). Levels of IL-8 and IL-6 interrelated (rs = 0.61, P < 0.01) and related to the elastase complexes (rs = 0.45, P < 0.05). Hence, our data support a role of cytokine-induced activation of neutrophils in the clinical severity of ARDS.

Original languageEnglish
Pages (from-to)746-52
Number of pages7
JournalCytokine Plus
Issue number7
Publication statusPublished - Oct 1995


  • Adult
  • Aged
  • Female
  • Humans
  • Hypoxaemia
  • Inflammation Mediators/blood
  • Intensive care unit
  • Interleukin-6/pharmacology
  • Interleukin-8/blood
  • Leukocyte Elastase/blood
  • Male
  • Mechanical ventilation
  • Middle Aged
  • Neutrophil Activation/immunology
  • Neutrophils/enzymology
  • Pancreatic Elastase/blood
  • Positive end-expiratory pressure
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Edema/diagnostic imaging
  • Pulmonary Edema/etiology
  • Respiratory Distress Syndrome, Adult
  • Respiratory Distress Syndrome, Adult/blood
  • Sepsis/complications
  • lung injury

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