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J Appl Physiol 70: 2640-2644, 1991;
8750-7587/91 $5.00
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Journal of Applied Physiology, Vol 70, Issue 6 2640-2644, Copyright © 1991 by American Physiological Society

ARTICLES

Endotoxemia and release of tumor necrosis factor and interleukin 1 alpha in acute heatstroke

A. Bouchama, R. S. Parhar, A. el-Yazigi, K. Sheth and S. al-Sedairy
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

To determine whether endotoxemia and release of tumor necrosis factor (TNF-alpha) and/or interleukin 1 alpha (IL-1 alpha) are involved in the pathogenesis of heatstroke, 17 adult patients with a mean rectal temperature of 42.1 +/- 0.2 degrees C were studied. Blood samples were taken on admission and after cooling was completed. TNF-alpha and IL-1 alpha levels were measured by enzyme-linked immunosorbent assay, and lipopolysaccharide (LPS) content was measured by the chromogenic substrate modification of the Limulus amebocyte lysate. TNF-alpha, IL-1 alpha, and LPS were elevated in all patients [199 +/- 25 (SE) pg/ml, 480.5 +/- 68.3 pg/ml, and 8.60 +/- 1.19 ng/ml, respectively, compared with normal control values of 31.4 +/- 8.4 pg/ml, 53.7 +/- 5.32 pg/ml, and less than 9 pg/ml]. There was no significant correlation between temperature and the circulating concentration of TNF-alpha, IL-1 alpha, and LPS. Postcooling TNF-alpha, IL-1 alpha, and LPS concentrations were significantly decreased but still above normal control values. The findings suggest that these mediators may have a role in the pathogenesis of heatstroke that could change the strategy of management.


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