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Table 2 Studies measuring cytokines in patients with or at risk for ARDS

From: Serum biomarkers in Acute Respiratory Distress Syndrome an ailing prognosticator

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
  1. 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
  2. a: Use the American European Consensus Conference definitions