Respiratory burst capability of polymorphonuclear neutrophils and TNF-a serum levels in relationship to the development ofseptic syndrome in critically ill patients.j Leukoc

Activated polymorphonuclear neutrophils (PMN) and neutrophil activating mediators such as tumor necrosis factor-a (TNF-a) are thought to be involved in the pathophysiol-ogy of sepsis and multiple organ failure syndrome (MOFS). In critically ill patients at high risk for the development of septic syndrome (n = 17) peripheral blood PMN were assayed for O and H202 production after stimulation with phorbol myristate acetate (PMA, 40 nM). Serum TNF-a levels were determined by ELISA. At the time of admission to the intensive care unit we found significant higher levels of TNF-a (P = 0.0001) in the serum of patients finally developing sepsis correlating to higher respiratory burst capability in comparison to nonseptic patients. Additionally we were able to demonstrate a significant (P = 0.0016) lower dismutation rate of O to H202 in deceased patients in comparison to survivors. These results give further evidence that elevated levels of circulating TNF-a and activated PMN play a significant role in the pathogenesis of septic syndrome in critically ill patients. Key words: sepsis, superoxide-hydrogen peroxide-productio