The role of resistin and myeloperoxidase in severe sepsis and septic shock: Results from the ALBIOS trial
| Autor: | Pietro Caironi, Edoardo Elia, Aldo Bonaventura, Fabrizio Montecucco, Roberto Keim, Deborah Novelli, Jennifer Meessen, Eduardo Beck, Federico Carbone, Roberto Latini, Sandra Ferraris, Anna Maria Ansaldo, Silvia Minetti, Alessandra Vecchié, Daniele Ferrara |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Neutrophils Clinical Biochemistry 030204 cardiovascular system & hematology Biochemistry Gastroenterology Sepsis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient Resistin 030212 general & internal medicine Mortality Severe sepsis Aged Peroxidase Randomized Controlled Trials as Topic biology business.industry Septic shock Septic Hazard ratio Albumin myeloperoxidase neutrophils prognosis resistin septic shock severe sepsis Disease Progression Female Fluid Therapy Middle Aged Prognosis Shock Septic nutritional and metabolic diseases Shock General Medicine respiratory system medicine.disease Myeloperoxidase biology.protein business hormones hormone substitutes and hormone antagonists |
| Popis: | Background Inflammatory biomarkers are useful in detecting patients with sepsis. The prognostic role of resistin and myeloperoxidase (MPO) has been investigated in sepsis. Materials and methods Plasma resistin and MPO were measured on days 1, 2 and 7 in 957 patients enrolled in the Albumin Italian Outcome Sepsis (ALBIOS) trial. The association between resistin and MPO levels on day 1, 2 and 7 and 90-day mortality was assessed. Results Plasma resistin and MPO concentrations were higher at day 1 and decreased until day 7. Both biomarkers were positively correlated with each other and with physiological parameters. Higher levels of resistin and MPO on day 1 were associated with the development of new organ failures. Patients experiencing death at 90 days showed higher levels of resistin and MPO compared with survivors. At day 1, only MPO in the 4th quartile (Q4), but not resistin, was found to predict 90-day death (adjusted hazard ratio [aHR] 1.55 vs Q1). At day 2, resistin in the Q3 and Q4 predicted a > 40% increase in mortality as also did MPO in the Q4. On day 7, Q4 resistin was able to predict 90-day mortality, while all quartiles of MPO were not. Conclusions High levels of MPO, but not of resistin, on day 1 were able to predict 90-day mortality. These findings may either suggest that early hyper-activation of neutrophils is detrimental in patients with sepsis or reflect the burden of the inflammatory process caused by sepsis. Further studies are warranted to deepen these aspects (ALBIOS ClinicalTrials.gov Identifier: NCT00707122). |
| Databáze: | OpenAIRE |
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