INTRODUCTION. Systemic inflammatory response syndrome (SIRS) is a common syndrome in the intensive care unit that may progress to severe sepsis or septic shock. It is believed that severe sepsis and septic shock are accompanied by the inability to regulate the inflammatory response shown by an imbalance in the pro- and anti-inflammatory response. The aim of this study was to measure potential markers in patients with SIRS, severe sepsis or septic shock that may predict progression of disease and clinical outcome. METHODS. We measured the level of soluble mediators osteopontin (OPN), IL4, IL5, IL10, TNF- α and INF-gamma as well as markers of T-cell activation H4/ICOS, CD69, CD25 and HLA-DR in pa- tients with SIRS, severe sepsis, septic shock and healthy controls. Additional blood samples were taken when patients progressed to a different stage and when patients recovered and did not meet the criteria defining SIRS. RESULTS. Plasma OPN levels (ng/ml) were significantly increased in patients with SIRS as com- pared to healthy controls. In the more severe stages OPN increased further, while levels decreased when patients recovered (see table). No differences were observed in the levels of IL10, TNF- α , INF- gamma, IL4 or IL5. In patients, the analysis of the markers of T-cell activation showed an expected increase in levels of CD25, CD69 and HLA-DR as compared to the controls. Levels decreased when patients recovered. Of special interest, levels of H4/ICOS (% positive cells) were increased in patients as compared to controls, however levels continued to increase during the recovery of the septic process. TABLE 1. Control SIRS Severe Sepsis Septic shock Sepsis recovery OPN ng/ml 125 (141 ± 127) 780 (940 ± 460) > 2500 > 2500 607 (687 ± 262) H4/ICOS 11 (15 ± 19) 40 (29 ± 21) 36 (44 ± 34) 45 (42 ± 28) 75 (62 ± 37) Values expressed as median (mean ± SD) CONCLUSION. This study suggests that OPN and H4/ICOS may be considered new markers in sep- sis. OPN appears to correlate with the severity of sepsis and may play a role in the pro-inflammatory response. H4/ICOS positive T-cells are likely part of the anti-inflammatory response and therefore may play a role in the recovery of sepsis. However, more research is needed to establish predictive roles for these markers. Grant acknowledgement. Regione Piemonte.
OSTEOPONTIN AND H4/ICOS: NEW MARKERS FOR SEPSIS?
VASCHETTO, Rosanna;Chiocchetti A;Della Corte F.
2006-01-01
Abstract
INTRODUCTION. Systemic inflammatory response syndrome (SIRS) is a common syndrome in the intensive care unit that may progress to severe sepsis or septic shock. It is believed that severe sepsis and septic shock are accompanied by the inability to regulate the inflammatory response shown by an imbalance in the pro- and anti-inflammatory response. The aim of this study was to measure potential markers in patients with SIRS, severe sepsis or septic shock that may predict progression of disease and clinical outcome. METHODS. We measured the level of soluble mediators osteopontin (OPN), IL4, IL5, IL10, TNF- α and INF-gamma as well as markers of T-cell activation H4/ICOS, CD69, CD25 and HLA-DR in pa- tients with SIRS, severe sepsis, septic shock and healthy controls. Additional blood samples were taken when patients progressed to a different stage and when patients recovered and did not meet the criteria defining SIRS. RESULTS. Plasma OPN levels (ng/ml) were significantly increased in patients with SIRS as com- pared to healthy controls. In the more severe stages OPN increased further, while levels decreased when patients recovered (see table). No differences were observed in the levels of IL10, TNF- α , INF- gamma, IL4 or IL5. In patients, the analysis of the markers of T-cell activation showed an expected increase in levels of CD25, CD69 and HLA-DR as compared to the controls. Levels decreased when patients recovered. Of special interest, levels of H4/ICOS (% positive cells) were increased in patients as compared to controls, however levels continued to increase during the recovery of the septic process. TABLE 1. Control SIRS Severe Sepsis Septic shock Sepsis recovery OPN ng/ml 125 (141 ± 127) 780 (940 ± 460) > 2500 > 2500 607 (687 ± 262) H4/ICOS 11 (15 ± 19) 40 (29 ± 21) 36 (44 ± 34) 45 (42 ± 28) 75 (62 ± 37) Values expressed as median (mean ± SD) CONCLUSION. This study suggests that OPN and H4/ICOS may be considered new markers in sep- sis. OPN appears to correlate with the severity of sepsis and may play a role in the pro-inflammatory response. H4/ICOS positive T-cells are likely part of the anti-inflammatory response and therefore may play a role in the recovery of sepsis. However, more research is needed to establish predictive roles for these markers. Grant acknowledgement. Regione Piemonte.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
