Macrophage Migration Inhibitory Factor And Hypothalamo-Pituitary-Adrenal Function During Critical Illness

Macrophage migration inhibitory factor (MIF) is a multifunctional mediator with pituitary hormone, pro-inFlammatory cytokine and catalytic enzyme activities1. MIF has the capacity to override the anti-inFlammatory and immunosuppressive actions of glucocorticoids (GCs)2. MIF production is induced by low concentrations of GCs, but also by cytokines and stress activation. We evaluated the intriguing role of MIF in the complex network of immuno-neuroendocrine adaptation3 during critical illness, by measuring blood levels of MIF and its relation with the HPA-axis, the acute phase response, cytokines, the severity of illness and ICU mortality.