[Inhibitor of the extrinsic pathway of coagulation and cytokines in patients with sepsis].
To analyse the possible correlation between the plasma levels of the extrinsic pathway inhibitor (TFPI) in patients with infection along with two cytokines mediating in the action of bacterial endotoxin on the vascular endothelium, namely, tumour factor (TNF) and interleukin-1 (IL-1). Twenty-five patients with infection, none of them showing septic shock or disseminated intravascular coagulation, were studied. Plasma TFPI concentration was assessed by a chromogenic substrate technique; TNF was determined with immunoradiometric methods and IL-1 was estimated with ELISA. The results were compared with those of a group of 25 healthy subjects matched for age and sex. Positive blood cultures were found in 15 of the 25 patients (60%), 12 due to gram-negative and 3 to gram-positive germs. A significant increase of TFPI (p < 0.004), TNF and IL-1 (p < 0.001) was found in infection patients with respect to the control subjects. No significant correlation between TFPI and TNF or IL-1 was found. Increased TFPI, unrelated to cytokines, is present in patients with sepsis.