The Role of IL-1, IL-6, TNF-α and MIF in Relative Adrenal Insufficiency in Septic Shock: A Study in Piglet Model

Abstract

Introduction: Incidence of adrenal insufficiency is high. This study aimed to identify the role of IL-6, IL-1, TNF-α and MIF in septic shock with relative adrenal insufficiency (RAI) in order to develop guidelines for biomarker. Methods: Experimental study conducted in Veterinary Medicine for 6 months. Piglet models aged 6-8 weeks and 5-10 kg. Consecutive sampling was used with total 20 piglets. Piglet were given 50 ug/kg endotoxin (Escherichia coli; Sigma chemical, USA) and were monitored using PiCCO monitor. Blood sample was collected every 15 minutes until septic shock occurred. Corticotropine stimulation test and immunohistochemistry examination were performed. Result: From 19 study subjects had septic shock in 60 minutes. The level of IL-6 at 45 minutes had a significant different compared to the group without RAI ( p = 0.008). The level of IL-1 during septic shock were not significantly different. The level of TNF-α in RAI group had significant different at 15 minutes ( p = 0.002) and at 30 minutes ( p = 0.007) The level of MIF in RAI group during septic shock had a significant different (p = 0.003). Immunohistochemistry staining observed only in the hypothalamus glands of the RAI group. Conclusion: TNF-α increased in earlier minutes, then IL-6 increased and MIF increased in septic shock condition. IL=1 level had no difference for both group. Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Declaration of Interest: The authors declares that they have no competing interests Ethical Approval: The study was conducted for 6 months (April – September 2015) and was started after obtaining ethical review approval from Medical/Health Research Ethics Committee of the Faculty of Medicine, University of Indonesia/RSUPN Dr. Cipto Mangunkusumo (No. 939/UN2.F1/ETIK/X/2015) and an approval from the Animal Ethics Committee of the Veterinary Faculty, Bogor Agricultural Institute (No. 026/KEH/SKE/IV/2015).