{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:05:39Z","timestamp":1791295539663,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[1992,5,1]],"date-time":"1992-05-01T00:00:00Z","timestamp":704678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1992,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Intrapulmonary activation of leukocytes and release of cellular mediators and enzymes are involved in the pathophysiology of the adult respiratory distress syndrome (ARDS). To investigate a possible role of local cytokines, we measured bronchoalveolar fluid (BALF) and plasma levels of tumor necrosis factor a (TNF-\u03b1) and its soluble inhibitors (sTNF-RI + RII), interleukin-1\u03b2 (IL-1\u03b2), interferon-\u03b1 (IFN-\u03b1), and granulocyte elastase in 14 patients at risk for ARDS and in 35 patients developing ARDS after trauma, sepsis, or shock. During clinical development of severe ARDS, BALF cytoklnes increased markedly: TNF-\u03b1 from 116 \u00b1 36 to 10,731 \u00b1 5,048 pg\/ml (mean \u00b1 SEM), p = 0.001; sTNF-RI + RII from 3.7 \u00b1 1.4 to 24.6 \u00b1 2.6 ng\/ml, p &amp;lt; 0.05; and IL-1\u03b2 from 7,746 \u00b1 5,551 to 42,255 \u00b1 19,176 pg\/ml, p = 0.01. Plasma cytoklnes were not increased in most patients, nor were they correlated with the development or severity of ARDS. BALF elastase was higher in patients developing ARDS than in those at risk but not going into pulmonary failure (0.97 \u00b1 0.26 versus 0.28 \u00b1 0.13 U\/ml, p = 0.026), and the highest values were observed in the early stages of severe ARDS (1.85 \u00b1 0.39 U\/ml). BALF elastase levels correlated with IFN-\u03b1 (r = 0.72, p &amp;lt; 0.001). In conclusion, local release of TNF-\u03b1 and IL-1\u03b2, possibly by pulmonary macrophages or other cells, and\/or accumulation in the lung is associated with the development of ARDS. TNF-\u03b1 recovered in BALF was found biologically inactive; this may be due to the presence of substantial amounts of its inhibitors. Increased IFN-\u03b1 and elastase in BALF probably reflect intrapulmonary granulocyte activation and degranulation.<\/jats:p>","DOI":"10.1164\/ajrccm\/145.5.1016","type":"journal-article","created":{"date-parts":[[2011,8,3]],"date-time":"2011-08-03T16:22:09Z","timestamp":1312388529000},"page":"1016-1022","source":"Crossref","is-referenced-by-count":401,"title":["High Bronchoalveolar Levels of Tumor Necrosis Factor and Its Inhibitors, Interleukin-1, Interferon, and Elastase, in Patients with Adult Respiratory Distress Syndrome after Trauma, Shock, or Sepsis"],"prefix":"10.1093","volume":"145","author":[{"given":"Peter M.","family":"Suter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Suter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Girardin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Roux-Lombard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges E.","family":"Grau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Dayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1992,5,1]]},"reference":[{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198204153061504"},{"key":"p_7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198004033021407"},{"key":"p_10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.89.4.590"},{"key":"p_18","doi-asserted-by":"publisher","DOI":"10.1172\/JCI112980"},{"key":"p_23","first-page":"218","volume":"133","year":"1986","journal-title":"Dis"},{"key":"p_25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198902093200606"},{"key":"p_29","doi-asserted-by":"publisher","DOI":"10.1172\/JCI110823"},{"key":"p_50","unstructured":"release of interleukin 1. 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