Table 2

Studies measuring cytokines in patients with or at risk for ARDS

Investigator
Patients Controls
Biomarker / Summary
ROC curve analysis Cut-off values
Specificity – Sensitivity PPV – NPV
Limitations

Pinsky et al. 13
52 at risk
Relation of IL-6 and TNF plasma levels to multiple-system organ failure and mortality
No
Not estimated
Small number of patients
No ROC curve analysis / cut-off levels
No serial measurement
Takala et al. 14
20 at risk
56 controls
IL-6 and IL-8 plasma levels predict organ failure in community-acquired septic shock
No
Not estimated
Small number of patients
No ROC curve analysis / cut-off levels
Poor discriminative value of serum biomarkers per se
Calandra et al. 15
70 at risk
IL-6 plasma levels do not predict the outcome in at risk patients for ARDS
No
Not reported
Small number of patients
No ROC curve analysis
Kiehl et al. 16
19 at risk
TNFa, IL-6, IL-8 plasma levels fail to associate with severity and course of ARDS in leukocytopenic patients
No
Not estimated
Small number of patients
No ROC curve analysis / cut-off levels
Leukocytopenic patients
Meduri et al. 18
27 ARDS
TNFa, IL-1β, IL-2, IL-4, IL-6, IL-8
Superiority of IL-1β and IL-6 plasma levels in monitoring disease activity over commonly applied clinicophysiologic parameters.
Yes
TNFa: 400 pg/ml
IL-1β: 400 pg/ml
IL-2: 200 pg/ml
IL-4: 200 pg/ml
IL-6: 400 pg/ml
IL-8: 400 pg/ml
TNFa: 89-50-85-57%
IL-1β: 78-83-83-78%
IL-2: 89-83-90-80%
IL-4: 89-50-85-57%
IL-6: 77-75-81-70%
IL-8: 66-50-66-50%
Small number of patients
Perspective study
Overlap of cytokine levels between survivors and non-survivors
Heterogeneity of studied population
Definition criteria of ARDS
Agouridakis et al. 19
8 ARDSa
26 at risk
Association between increased levels of IL-2 and IL-15 and outcome in patients with early ARDS
Yes
IL-2: 173 pg/ml
IL-15: 250 pg/ml
IL-2: 100-100-100-100% IL-15: 100-100-100-100%
Small number of patients
Limited number of studied molecules

Abbreviations: ARDS: Acute Respiratory Distress Syndrome, BALF: Bronchoalveolar lavage Fluid, IL: Interleukin, NPV: Negative Predictive Value, PPV: Positive Predictive Value, ROC: Receiver Operating Characteristic, sIL-2R: soluble interleukin-2 receptor, TNFa: Tumor Necrosis Factor-alpha

a: Use the American European Consensus Conference definitions

Tzouvelekis et al. Respiratory Research 2005 6:62   doi:10.1186/1465-9921-6-62