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Functional analysis of eicosanoids from white blood cells in sepsis and SIRS

100%
Sepsis and SIRS are affections with major alterations in inflammatory activity. The impact of prostaglandins (PG) and leukotrienes (LT) produced from white blood cells (WBC) in this context is not completely understood. Thirty nine patients with sepsis or SIRS were investigated in comparison to 10 healthy controls. WBC were collected and separately exposed to arachidonic acid (AA) or to nothing else. After centrifugation, the generated PGE2 and LTCDE4 with or without stimulation were measured in the supernatant. LT-levels were significantly higher during sepsis/SIRS than in controls whereas PG-levels of patients were decreased to those of controls in basic condition. The relation between the level with and without stimulation showed a significant higher ratio in PG in contrast to LTs. The survivor’s ratio in LT levels was significantly higher than that of non-survivors, which did not differ from controls. Generation of LT from WBC is enhanced during sepsis/SIRS, but LT generation after stimulation only in survivors but not in non-survivors. This inability of WBC to generate LT during sepsis in non-survivors could be predictive regarding the outcome of sepsis/SIRS and may be part of the “immunoparalysis” seen during sepsis in association with bad outcome.
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Functional-eicosanoid-test (FET) and disease

80%
Eicosanoids are involved in most cellular activities. Measurement of their levels in tissue or blood renders information about the function of activated cells. An extended analysis will improve the conclusions regarding eicosanoid-related diseases. Peripheral white blood cells (WBC) were used for the test. Stimulating or inhibiting substances to influence the generation and the metabolism of eicosanoids were separately added to the samples. Prostaglandins (PG) and leukotrienes (LT) were measured after incubation in culture medium for 20 minutes at room temperature. Healthy controls rendered normal data. Patients with intolerance to acetylsalicylic acid (ASS) showed an elevated output of PG and LT upon stimulation. Addition of ASS shifted from PG to LT. An altered pattern of eicosanoids also was found in patients suffering from gastroduodenal ulcer and in intestinal malignancy. The senstivity regarding the ASS-intolerance is >80% and the specifity in the same group >70%. We concluded that the FET is a suitable test for the demonstration and verification of intolerance to ASS. It also detects an imbalance of the eicosanoids in intestinal malignancy. This makes the FET a helpful tool for diagnosis and for the elucidation of pathogenic mechanisms.
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