Erfina Lim, Jusak Nugraha


Introduction. Sepsis is a cause of non-cardiac death in the hospital. Early and rapid diagnosis of sepsis patients is a challenge to increase the expectancy of life. IL-6 and TNF-α are groups of proinflammatory cytokines that initiate an initial inflammatory response. Procalcitonin is a specific marker of bacterial infection. This study aimed to analyze the correlation of serum cytokine IL-6, TNF-α, procalcitonin and leukocyte count in  suspected sepsis patients.

Methods. This was a cross-sectional observational study.  The study subjects consisted of 45 patients with suspected sepsis who were examined for procalcitonin level > 0.5 ng/mL. Procalcitonin examination by  ELFA (VIDAS) , IL-6 and TNF- α used U-CyTech Human Elisa kit (Bioscience, INC) and leukocyte counts with SYSMEX-XN 1000.

Results. The levels of IL-6 ranged 0 pg/mL – 73.29 ng/mL (mean 29.43 ng/mL). The values for TNF- α were 0 pg/mL – 390.5 pg/mL (mean 27.62 pg/mL). The mean value of  leukocytes was 20,139/ μL. There was no correlation between leukocyte counts with IL-6 ( p = 0.798 and r = 0.040),  TNF- α (p = 0.304 and r = -0.160),  Procalcitonin ( p = 0.323 and r = 0.154). There was no correlation between  IL-6 levels with  TNF-α levels (p = 0.871 and r = -0.025), procalcitonin levels ( p = 0.466 and r = 0.112).  There was a weak negative correlation between TNF- α  level and procalcitonin levels ( p=0.006 and r = -0.403)

Conclusion. There was a weak negative correlation between the level of procalcitonin with TNF- α in suspected sepsis patients.


Sepsis, Procalcitonin, IL-6, TNF- α


Levy MM, Dellinger RP, Townsend SR, Linde-Zwirble WT, Marshall JC, et al (2010) The Surviving Sepsis Campaign: results of an international guideline based performance improvement program targeting severe sepsis. Intensive Care Med 36:222–231

Pugin J , Meisner M, Leon A, Gendrel D, Lopez AF. Guide for the Clinical Use of Procalcitonin (PCT). Thermo Fisher Scientific Inc. Edisi 10. Januari 2011.

Riedel S, Melendez JH, An AT, Rosenbaum JE, Zenilman JM. Procalcitonin as a Marker for the Detection of Bacteremia and Sepsis in the Emergency Department. American Society for Clinical Pathology 2011; 135: 182-189.

Muller B, Becker KL, Schachinger H, Rickenbacher PR, Huber PR, Zimmerli W, Ritz R; Calcitonin precursors are reliable markers for sepsis in a medical intensive care unit. Crit care Med 2000, 28:977-983.

Correia, J.W., Freitas, M.V., Querioz, J.A., Perrin, M.P. and Cavadas, B. 2009. ‘Interleukin-6 blood levels in sensitive and multiresistant tuberculosis’, Infection, 37, pp. 138-141. doi:10.1007/s15010-008-7398-3.

Lloyd MM, Kuyl JM. Comparison of three methods for procalcitonin analysis. Med Tech. June 2012:26(1);48-51.

Arifijanto M V. 2015. Sepsis. In A. Tjokropprawiro A et al., eds. Buku Ajar Ilmu Penyakit Dalam. 2nd ed. Surabaya: Airlangga University Press. pp.701-707.

Ma’at, Suprapto, 2012. Inflamasi. Pusat Penerbitan dan Percetakan UNAIR (AUP). Edisi 1. Hal 18.

Stearns-Kurosawa DJ, Osuchowski MF, Valentine C, Kurosawa S, Remick DG, 2011. ‘The Pathogenesis of Sepsis’. Annual Review of Pathology Mechanisms of Disease, 6, pp.19-48.

Pettila V, Hynninen M, Takkunen O, Kuusela P, Valtonen M. Predictive value of procalcitonin and interleukin 6 in critically ill patients with suspected sepsis. Intensive Care Med. 2002;28:1220–1225.

Spooner E C, Markowitz PN, Sarawlatz PL, 1992. The Role of Tumor Necrosis Factor in Sepsis. Journal Immunology and Immunopathology. Vol.62, pp.S11-S17.

Schuetz P, Chiappa V, Briel M, Greenwald JL. Procalcitonin algorithms for antibiotic therapy decisions. Arch Intern Med. 2011;171(15):1322-1331.

Magrini L, Gagliano G, Travaglino F, Vetrone F, Marino R, et al. Comparison between white blood cell count, procalcitonin and C reactive protein as diagnostic and prognostic biomarkes of infection or sepsis in patients presenting to the emergency department. Clin Chem Lab Med 2014; 52(10): 1465-1472.

Mozes T, Barath I, Gornicsar K, Grosz A, Gondocs Cs, et al. Deviations in Circulating TNF-α levels and TNF-α Production by Mononuclear Cells in Healthy Human Populations. Hindawi Mediators of inflammation 2011; p1-8.

Müller B, Becker KL. Procalcitonin: how a hormone became a marker and mediator of sepsis. Swiss Med Wkly. 2001 Oct 20; 131(41-42):595-602.

Dahaba AA, Metzier H., Procalcitonin’s role in the sepsis cascade. Is procalcitonin a sepsis marker or mediator? Minerva anestesiol.2009 Jul-Aug;75(7-8) :447-52. Epub 2008 Jan 24.

Wrenger S, Kahne T, Bohoun C, Weglohner W, Ansorge S, et al. Amino-terminal truncation of procalcitonin, a marker for systemic bacterial infections, by dipeptidyl peptidase IV (DP IV). 2000 Jan 21; 466(1):155-9.

van Langevelde P, Joop K, van Loon J, Frölich M, Groeneveld PH, et al Endotoxin, cytokines, and procalcitonin in febrile patients admitted to the hospital: identification of subjects at high risk of mortality. JT Clin Infect Dis. 2000 Dec; 31(6):1343-8.



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