Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2024; 12(23): 5374-5381
Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5374
Impact of interleukin 6 levels on acute lung injury risk and disease severity in critically ill sepsis patients
Ya Liu, Li Chen
Ya Liu, Li Chen, Department of Intensive Care Unit, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201900, China
Author contributions: The concept of this study was jointly proposed by Liu Y and Chen L, who participated in the data collection; Liu Y contributed to the formal analysis of this study, and drafted the initial draft; Chen L conducted the research, methodology, and visualization of the manuscript; Liu Y and Chen L participated in this study, validated it, and jointly reviewed and edited the manuscript.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of the Ninth Affiliated People's Hospital of Shanghai Jiao Tong University School of Medicine.
Informed consent statement: This study has obtained informed consent forms signed by patients and guardians.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No data available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Chen, MS, Doctor, Department of Intensive Care Unit, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Room 504, Building 14, Baosteel Ba Village Community, Baoshan District, Shanghai 201900, China. wwqh480@163.com
Received: April 24, 2024
Revised: May 16, 2024
Accepted: June 4, 2024
Published online: August 16, 2024
Processing time: 71 Days and 21 Hours
Abstract
BACKGROUND

Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury (ALI) and multiple organ dysfunction syndrome (MODS). Interleukin 6 (IL-6) is a pro-inflammatory cytokine that plays a crucial role in the pathogenesis of sepsis and its complications.

AIM

To investigate the relationship among plasma IL-6 levels, risk of ALI, and disease severity in critically ill patients with sepsis.

METHODS

This prospective and observational study was conducted in the intensive care unit of a tertiary care hospital between January 2021 and December 2022. A total of 83 septic patients were enrolled. Plasma IL-6 levels were measured upon admission using an enzyme-linked immunosorbent assay. The development of ALI and MODS was monitored during hospitalization. Disease severity was evaluated by Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores.

RESULTS

Among the 83 patients with sepsis, 38 (45.8%) developed ALI and 29 (34.9%) developed MODS. Plasma IL-6 levels were significantly higher in patients who developed ALI than in those without ALI (median: 125.6 pg/mL vs 48.3 pg/mL; P < 0.001). Similarly, patients with MODS had higher IL-6 levels than those without MODS (median: 142.9 pg/mL vs 58.7 pg/mL; P < 0.001). Plasma IL-6 levels were strongly and positively correlated with APACHE II (r = 0.72; P < 0.001) and SOFA scores (r = 0.68; P < 0.001).

CONCLUSION

Elevated plasma IL-6 levels in critically ill patients with sepsis were associated with an increased risk of ALI and MODS. Higher IL-6 levels were correlated with greater disease severity, as reflected by higher APACHE II and SOFA scores. These findings suggest that IL-6 may serve as a biomarker for predicting the development of ALI and disease severity in patients with sepsis.

Keywords: Sepsis, Acute lung injury, Multiple organ dysfunction syndrome, Interleukin-6, Biomarker, Disease severity

Core Tip: Elevated plasma interleukin-6 (IL-6) levels in septic patients indicate a higher risk of acute lung injury and multiple organ dysfunction syndrome. Monitoring IL-6 levels can help predict disease severity and the development of complications in critically ill patients with sepsis, making it a potential valuable biomarker for early intervention and management strategies.