HIGH ACTIVITY OF INDOLEAMINE 2,3 DIOXYGENASE ENZYME PREDICTS DISEASE SEVERITY AND CASE FATALITY IN BACTEREMIC PATIENTS
Autor: | Reetta Huttunen, M. Pertovaara, Janne Aittoniemi, Simo S. Oja, Janne Laine, A. Raitala, Jaana Syrjänen, Risto Vuento, Heini Huhtala, Mikko Hurme |
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Rok vydání: | 2010 |
Předmět: |
Adult
Male medicine.medical_specialty Bacteremia Critical Care and Intensive Care Medicine medicine.disease_cause Gastroenterology Sepsis Young Adult chemistry.chemical_compound Internal medicine Streptococcus pneumoniae Case fatality rate medicine Humans Indoleamine-Pyrrole 2 3 -Dioxygenase Risk factor Indoleamine 2 3-dioxygenase Chromatography High Pressure Liquid Kynurenine Aged 80 and over business.industry Tryptophan Odds ratio Middle Aged medicine.disease chemistry Immunology Emergency Medicine Female business |
Zdroj: | Shock. 33:149-154 |
ISSN: | 1073-2322 |
DOI: | 10.1097/shk.0b013e3181ad3195 |
Popis: | Indoleamine 2,3-dioxygenase (IDO), which is the rate-limiting enzyme for tryptophan (trp) catabolism, may play a critical role in various inflammatory disorders. Recent studies on trauma patients have suggested that the degradation of trp is associated with the development of sepsis. The role of IDO activity in bacteremic patients is unclear. We studied IDO activity in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, beta-hemolytic streptococcae, or Eschericia coli. The serum concentrations of trp and its metabolite kynurenine (kyn) were measured by reverse-phase high-performance liquid chromatography 1 to 4 days after the positive blood culture and on recovery. The kyn-to-trp ratio (kyn/trp), reflecting the activity of the IDO enzyme, was calculated. The maximum value in the ratio for every patient during 1 to 4 days after positive blood culture was used in analysis. The maximum kyn/trp ratio was significantly higher in nonsurvivors versus those who survived (193.7 vs. 82.4 micromol/mmol; P = 0.001). The AUC(ROC) of maximal kyn/trp in the prediction of case fatality was 0.75 (95% confidence interval, 0.64-0.87), and the kyn/trp ratio at a cutoff level of 120 micromol/mmol showed 83% sensitivity and 69% specificity for fatal disease. A kyn/trp ratio greater than 120 micromol/mmol was associated with increased risk of death versus low ( |
Databáze: | OpenAIRE |
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