IL-6, MMP 3 and prognosis in previously healthy sepsis patients

Resumo

Sepsis and septic shock are clinical conditions with high mortality despite advances in technology and are the leading cause of death in intensive care. Clinical manifestations and morbidity may be attributable to a disproportionate increase in proinflammatory cytokines. The aim of this study was to evaluate the ability to predict mortality from interleukin 6 [IL-6] and matrix metalloproteinase 3 [MMP-3]. This single-center, observational, prospective study included 48 adult patients admitted to the Hospital Nacional de Clinicas in Cordoba, Argentina, with sepsis or septic shock. Serum levels of IL-6 and MMP-3 were measured at the time of diagnosis and 72 hours later. At time of admission, MMP-3 was 13.77 mg/ml in patients who died and 10.55 mg/ml in patients who survived up to 28 days after hospitalization [p = 0.012], while IL-6 did not differ between the groups. The change in IL-6 over 72 hours was increased in nonsurvivors by 21.11 ± 11.81 pg/ml and decreased in survivors by 40.87 ± 14.94 pg/ml [p = 0.007]. No difference in the change of MMP-3 over 72 hours was observed between survivors and nonsurvivors. This study shows that MMP-3 at admission and the change in IL-6 over the first 72 hours of hospitalization could provide prognostic information in septic patients. Further studies are needed to define the utility of these cytokines as a measure of sepsis severity and as predictors of mortality.