Sepsis-induced acute respiratory distress syndrome with fatal outcome is associated to increased serum transforming growth factor beta-1 levels

European Journal of Internal Medicine , 05/09/2012

De Pablo R et al. – In patients with septic shock, persistent ARDS is accompanied with increased circulating TGF–(beta)1 levels. Furthermore, Acute Respiratory Distress Syndrome (ARDS) patients with fatal outcome show higher TGF–(beta)1 concentrations than survivors. These results suggest the relevance of TGF–(beta)1 levels found in the pathogenesis of persistent sepsis–induced ARDS.

Methods

  • In this prospective pilot cohort study, serum bioactive TGF-β1 concentration, determined by sandwich ELISA, was analyzed in 52 patients who fulfilled criteria for septic shock at admission and on days 3 and 7.

Results

  • Of the 52 patients enrolled in the study, 46.1% fulfilled the criteria for ARDS on admission.
  • At ICU admission, there were not statistical differences in TGF-β1 concentrations between septic shock patients with or without ARDS.
  • After 7days of follow-up in ICU, circulating TGF-β1 levels were significantly higher in patients with sepsis and ARDS than in those without ARDS [55.47 (35.04–79.48pg/ml) versus 31.65 (22.89–45.63pg/ml), respectively] (p=0.002).
  • Furthermore, in septic shock associated ARDS patients, TGF-β1 levels were significantly higher in nonsurvivors than in survivors [85.23 (78.19–96.30pg/ml) versus 36.41 (30.21–55.47pg/ml), respectively] (p=0.006) on day 7 of ICU follow-up.

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