Cytokine Balance in the Lungs of Patients with Acute Respiratory Distress Syndrome
Abstract
Acute respiratory distress syndrome (ARDS) involves an intense inflammatory response in the lungs, with accumulation of both pro- and antiinflammatory cytokines in bronchoalveolar lavage fluid (BALF). Our goal was to determine how the balance between pro- and antiinflammatory mediators in the lungs changes before and after the onset of ARDS. We identified 23 patients at risk for ARDS and 46 with established ARDS and performed serial bronchoalveolar lavage (BAL). We used immunoassays to measure tumor necrosis factor α (TNF- α) and soluble TNF- α receptors I and II; interleukin 1 β (IL-1 β), IL-1 β receptor antagonist, and soluble IL-1 receptor II; IL-6 and soluble IL-6 receptor; and IL-10. We used sensitive bioassays to measure net TNF- α, IL-1 β, and IL-6 activity. Although individual cytokines increased before and after onset of ARDS, greater increases occurred in cognate receptors and/or antagonists, so that molar ratios of agonists/antagonists declined dramatically at the onset of ARDS. The molar ratios remained low for 7 d or longer, limiting the activity of soluble IL-1 β and TNF- α in the lungs at the onset of ARDS. This significant antiinflammatory response early in ARDS may provide a key mechanism for limiting the net inflammatory response in the lungs.
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The intensity of the inflammatory response in the lungs reflects a balance between proinflammatory cytokines and their cognate soluble receptors or inhibitors, which inhibit the activity of these inflammatory cytokines in the aqueous phase of alveolar fluid.
“The intensity of the inflammatory response in the lungs reflects a balance between proinflammatory cytokines (e.g., TNF and IL-1) and their cognate soluble receptors or inhibitors (TNFR1, TNFR2, and IL-1RA), which inhibit the activity of these inflammatory cytokines in the aqueous phase of alveolar fluid (113).”
From Into the Eye of the Cytokine Storm (2012) · cites this paper as [113]
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- Authors
- PARK, W. Y., GOODMAN, R. B., STEINBERG, K. P., RUZINSKI, J. T., RADELLA, F., PARK, D. R., PUGIN, J., SKERRETT, S. J., HUDSON, L. D., & MARTIN, T. R.
- Affiliations
- University of Geneva (CH)
- Section of Pulmonary/Critical Care Medicine, Harborview Medical Center, Medical Research Service of the VA Puget Sound Health Care System; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington; and Department of Medical Intensive Care, University of Geneva Medical Center, Geneva, Switzerland
- ORCID
- SKERRETT, SHAWN J.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-11
- Volume
- 164
- Issue
- 10
- Pages
- 1896-1903
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2093084020
- Cited by
- 547
- References
- 47
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 8 · 2023: 18 · 2022: 25 · 2021: 43 · 2020: 44 · 2019: 22 · 2018: 18 · 2017: 17 · 2016: 17 · 2015: 20 · 2014: 22 · 2013: 19 · 2012: 26
- FWCI
- 16.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ai029103-08)
- National Heart, Lung, and Blood Institute (P50HL030542, HL-30542)
- National Institute of Allergy and Infectious Diseases (AI-29103)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- acute respiratory distress syndrome, cytokine balance, bronchoalveolar lavage fluid, TNF-α, soluble TNF receptors, IL-1β, interleukin-6, soluble IL-6 receptor, IL-10, anti-inflammatory response, lung inflammation, cytokine antagonists
- MeSH terms
- Adult, Biological Assay, Bronchoalveolar Lavage Fluid, Female, Humans, Immunoassay, Inflammation, Interleukin-1, Lung, Male, Middle Aged, Prospective Studies, Respiratory Distress Syndrome, Risk Factors, Time Factors, Tumor Necrosis Factor-alpha, Antigens, CD, Interleukin-6, Case-Control Studies, Cytokines, Interleukin-10, Receptors, Interleukin-1, Receptors, Tumor Necrosis Factor, Inflammation Mediators, Receptors, Interleukin-6, Receptors, Tumor Necrosis Factor, Type I, Receptors, Tumor Necrosis Factor, Type II
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