Skip to main content
Springer Nature Link
Log in

Serial monitoring of interleukin-1β, soluble interleukin-2 receptor and lipopolysaccharide binding protein levels after death

A comparative evaluation of potential postmortem markers of sepsis

  • Original Article
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

We prospectively monitored the postmortem course of interleukin-1β (IL-1β), soluble interleukin-2 receptor (sIL-2R) and lipopolysaccharide binding protein (LBP) in septic and non-septic fatalities to evaluate their potential as biochemical postmortem markers of sepsis. Serum concentrations were determined by chemiluminescent immunometric assays. In both the sepsis group and the control group a postmortem increase of IL-1β levels with the progression of time after death was observed, in both groups mainly starting from the reference concentration of healthy individuals (5 pg/ml) and with no significant differences at later time points postmortem. SIL-2R (reference limit 1,000 U/ml) was highly elevated in all individuals included in the sepsis group at all time points postmortem with statistically significant differences between the sepsis and control groups (p<0.01). An excessive postmortem decrease of sIL-2R serum levels associated with progression of time after death was observed in all cases included in the sepsis group in contrast to just 1 out of 16 control cases. LBP (reference limit <10 g/ml) was elevated in all sepsis cases whereas in the control group LBP levels were below 10 µg/ml in 88%. The postmortem time course of LBP serum concentrations showed a continuous increase in both the sepsis and control groups. We conclude that sIL-2R and LBP seem to represent appropriate diagnostic tools for the postmortem diagnosis of sepsis in forensic autopsy practice. sIL-2R serum levels above 1,000 U/ml and LBP serum levels above 10 µg/ml in peripheral venous blood obtained in the early postmortem interval can be regarded as diagnostic hints for an underlying septic condition in a deceased person.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Adrie C, Pinsky MR (2000) The inflammatory balance in human sepsis. Intensive Care Med 26:364–375

    Article  CAS  PubMed  Google Scholar 

  2. Blackwell TS, Christman JW (1996) Sepsis and cytokines: current status. Br J Anaesth 77:110–117

    CAS  PubMed  Google Scholar 

  3. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference (1992) Definition for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874

    PubMed  Google Scholar 

  4. Bone RC (1996) The sepsis syndrome: definition and general approach to management. Clin Chest Med 17:175–181

    CAS  PubMed  Google Scholar 

  5. Schumann RR, Leong SR, Flaggs GW et al. (1990) Structure and function of lipopolysaccharide binding protein. Science 249:1429–1431

    CAS  PubMed  Google Scholar 

  6. Wright SD, Ramos RA, Tobias PS, Ulevitch RJ, Mathison JC (1990) CD14, a receptor for complexes of lipopolysaccharide (LPS) and LPS binding protein. Science 249:1431–1433

    CAS  PubMed  Google Scholar 

  7. Tocci MJ (1997) Structure and function of interleukin-1 beta converting enzyme. Vitam Horm 53:27–63

    CAS  PubMed  Google Scholar 

  8. Engel A, Kern WV, Mürdter G, Kern P (1994) Kinetics and correlation with body temperature of circulating interleukin-6, interleukin-8, tumor necrosis factor alpha and interleukin-1 beta in patients with fever and neutropenia. Infection 22:160–164

    CAS  PubMed  Google Scholar 

  9. Rubin LA, Nelson DL (1990) The soluble interleukin-2 receptor: biology, function, and clinical application. Ann Intern Med 113:619–627

    CAS  PubMed  Google Scholar 

  10. Pui C-H (1989) Serum interleukin-2 receptor: clinical and biological implications. Leukemia 3:323–327

    CAS  PubMed  Google Scholar 

  11. Martin C, Saux P, Mege JL, Perrin G, Papazian L, Gouin F (1994) Prognostic values of serum cytokines in septic shock. Intensive Care Med 20:272–277

    CAS  PubMed  Google Scholar 

  12. Terregino CA, Quinn JV, Slotman GJ (1997) Pilot study of cytokines in emergency department patients with systemic inflammatory response syndrome. Acad Emerg Med 4:684–688

    CAS  PubMed  Google Scholar 

  13. Terregino CA, Lopez BL, Karras DJ, Killian AJ, Arnold GK (2000) Endogenous mediators in emergency department patients with presumed sepsis: are levels associated with progression to severe sepsis and death? Ann Emerg Med 35:26–34

    CAS  PubMed  Google Scholar 

  14. Headley AS, Tolley E, Meduri GU (1997) Infections and the inflammatory response in acute respiratory distress syndrome. Chest 111:1306–1321

    CAS  PubMed  Google Scholar 

  15. Carlet J (1999) Rapid diagnostic methods in the detection of sepsis. Infect Dis Clin North Am 13:483–494

    CAS  PubMed  Google Scholar 

  16. Casey LC, Balk RA, Bone RC (1993) Plasma cytokine and endotoxin levels correlate with survival in patients with the sepsis syndrome. Ann Intern Med 119:771–778

    CAS  PubMed  Google Scholar 

  17. Spear ML, Stefano JL, Fawcett P, Proujansky R (1995) Soluble interleukin-2 receptor as a predictor of neonatal sepsis. J Pediatr 126:982–985

    CAS  PubMed  Google Scholar 

  18. Schumann RR, Lamping N, Kirschning C, Knopf H-P, Hoess A, Herrmann F (1994) Lipopolysaccharide binding protein: its role and therapeutical potential in inflammation and sepsis. Biochem Soc Trans 22:80–83

    CAS  PubMed  Google Scholar 

  19. Takala A, Jousela I, Jansson S-E et al. (1999) Markers of systemic inflammation predicting organ failure in community-acquired septic shock. Clin Sci 97:529–538

    Article  CAS  Google Scholar 

  20. Takala A, Jousela I, Takkunen O et al. (2002) A prospective study of inflammation markers in patients at risk of indirect acute lung injury. Shock 17:252–257

    Google Scholar 

  21. Rossi SJ, Schroeder TJ, Muth KL, Hanto DW, Balistreri WF, Ryckman FC (1994) Soluble interleukin-2 receptor monitoring during bacterial and viral infections in liver transplant recipients: a comparative evaluation. Clin Transplant 8:479–484

    CAS  PubMed  Google Scholar 

  22. Danieli MG, Paoletti A, Reccgioni A, Gabrielli A, Danieli G (1993) Serum levels of soluble interleukin-2 receptor in patients with systemic lupus erythematosus and systemic idiopathic vasculitis. Scand J Rheumatol 22:215–219

    CAS  PubMed  Google Scholar 

  23. Bouma M, Maessen J, Weerwind P, Dentener M, Fransen E, Jong D de, Buurman V (1997) Release of lipopolysaccharide toxicity-modulating proteins in patients undergoing cardiopulmonary bypass using noncoated and heparin coated extracorporal circuits. Chest 111:577–583

    CAS  PubMed  Google Scholar 

  24. Tsokos M, Püschel K (1999) Iatrogenic Staphylococcus aureus septicaemia following intravenous and intramuscular injections: clinical course and pathomorphological findings. Int J Legal Med 112:303–308

    Article  CAS  PubMed  Google Scholar 

  25. Tsokos M, Heinemann A, Püschel K (2000) Pressure sores: epidemiology, medico-legal implications and forensic argumentation concerning causality. Int J Legal Med 113:283–287

    Article  CAS  PubMed  Google Scholar 

  26. Feig JA, Cina SJ (2001) Evaluation of characteristics associated with acute splenitis (septic spleen) as markers of systemic infection. Arch Pathol Lab Med 125:888–891

    CAS  PubMed  Google Scholar 

  27. Tsokos M, Reichelt U, Nierhaus A, Püschel K (2001) Serum procalcitonin (PCT): a valuable biochemical parameter for the post-mortem diagnosis of sepsis. Int J Legal Med 114:237–243

    Article  CAS  PubMed  Google Scholar 

  28. Tsokos M, Reichelt U, Jung R, Nierhaus A, Püschel K (2001) Interleukin-6 and C-reactive protein serum levels in sepsis-related fatalities during the early postmortem period. Forensic Sci Int 119:47–56

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Pathology, University Hospital Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Uta Reichelt

  2. Department of Clinical Chemistry, University Hospital Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany

    Roman Jung

  3. Department of Anesthesiology, University Hospital Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany

    Axel Nierhaus

  4. Institute of Legal Medicine, University Hospital Eppendorf, Butenfeld 34, 22529 , Hamburg, Germany

    Michael Tsokos

Authors
  1. Uta Reichelt
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Roman Jung
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Axel Nierhaus
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Michael Tsokos
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Uta Reichelt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reichelt, U., Jung, R., Nierhaus, A. et al. Serial monitoring of interleukin-1β, soluble interleukin-2 receptor and lipopolysaccharide binding protein levels after death. Int J Legal Med 119, 80–87 (2005). https://doi.org/10.1007/s00414-004-0481-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-004-0481-0

Keywords