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Cui N, Zhang YY, Sun T, Lv XW, Dong XM, Chen N. Utilizing procalcitonin, C-reactive protein, and serum amyloid A in combination for diagnosing sepsis due to urinary tract infection. Int Urol Nephrol 2024; 56:2141-2146. [PMID: 38376659 DOI: 10.1007/s11255-024-03959-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE In this study, we aimed to evaluate the combined diagnostic value of procalcitonin (PCT), C-reactive protein (CRP), and serum amyloid A (SAA) in sepsis caused by urinary tract infection. METHOD A total of 80 patients with urosepsis who were hospitalized were included in the study group, and 80 patients with urinary tract infection without sepsis were included in the control group. We collected the PCT, SAA, and CRP levels of patients following admission. Subsequently, we conducted a comparative analysis to assess the specificity, accuracy, and sensitivity of combined diagnostic approaches in contrast to individual diagnostic methods for blood PCT, SAA, and CRP. RESULTS The levels of PCT, SAA, and CRP in the study group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.01). Multi-factor logistic regression analysis revealed that the levels of PCT (P = 0.003) and SAA (P = 0.014) were associated with urosepsis. The sensitivity of PCT was 87.133% and the specificity was 93.066%, which were higher than that of SAA and CRP. The specificity of the combined detection of the three was 95.670%, which was higher than that of PCT, SAA, and CRP alone. Correlation analysis revealed that PCT had a significant positive correlation with CRP and SAA (P < 0.01), and a weak correlation with white blood cell count (WBC) and fibrinogen (FIB) (P = 0.03 for WBC, P = 0.04 for FIB). CONCLUSION PCT, SAA, and CRP indicators in patients with urosepsis are significantly elevated, and all three are valuable in the diagnosis of urosepsis. PCT alone has good diagnostic efficiency for urosepsis, and a certain correlation with other inflammatory factors. The diagnostic efficacy of the three indicators in combination is better than that of any one of the three, and is worthy of widespread clinical application.
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Affiliation(s)
- Na Cui
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, No. 212 of Yuha Road, Lianchi District, Baoding, 071000, China
- Hebei Key Laboratory of Precise Imaging of Inflammation Related Tumors, Baoding, 071000, China
| | - Yuan-Yuan Zhang
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, No. 212 of Yuha Road, Lianchi District, Baoding, 071000, China
| | - Tao Sun
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, No. 212 of Yuha Road, Lianchi District, Baoding, 071000, China.
| | - Xiao-Wei Lv
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, No. 212 of Yuha Road, Lianchi District, Baoding, 071000, China
| | - Xu-Mei Dong
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, No. 212 of Yuha Road, Lianchi District, Baoding, 071000, China
| | - Ning Chen
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, No. 212 of Yuha Road, Lianchi District, Baoding, 071000, China
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Jing G, Zuo J, Liu Z, Liu H, Cheng M, Yuan M, Gong H, Wu X, Song X. Mendelian randomization analysis reveals causal associations of serum metabolites with sepsis and 28-day mortality. Sci Rep 2024; 14:11551. [PMID: 38773119 PMCID: PMC11109149 DOI: 10.1038/s41598-024-58160-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/26/2024] [Indexed: 05/23/2024] Open
Abstract
Metabolic disorder has been found to be an important factor in the pathogenesis and progression of sepsis. However, the causation of such an association between serum metabolites and sepsis has not been established. We conducted a two-sample Mendelian randomization (MR) study. A genome-wide association study of 486 human serum metabolites was used as the exposure, whereas sepsis and sepsis mortality within 28 days were set as the outcomes. In MR analysis, 6 serum metabolites were identified to be associated with an increased risk of sepsis, and 6 serum metabolites were found to be related to a reduced risk of sepsis. Furthermore, there were 9 metabolites positively associated with sepsis-related mortality, and 8 metabolites were negatively correlated with sepsis mortality. In addition, "glycolysis/gluconeogenesis" (p = 0.001), and "pyruvate metabolism" (p = 0.042) two metabolic pathways were associated with the incidence of sepsis. This MR study suggested that serum metabolites played significant roles in the pathogenesis of sepsis, which may provide helpful biomarkers for early disease diagnosis, therapeutic interventions, and prognostic assessments for sepsis.
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Affiliation(s)
- Guoqing Jing
- Research Centre of Anesthesiology and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jing Zuo
- Research Centre of Anesthesiology and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zhi Liu
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Huifan Liu
- Research Centre of Anesthesiology and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Miao Cheng
- Jingmen Central Hospital, Jingmen, Hubei, China
| | - Min Yuan
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hailong Gong
- Research Centre of Anesthesiology and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiaojing Wu
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
| | - Xuemin Song
- Research Centre of Anesthesiology and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
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Li L, Liu H, Zhang Q, Jin H, Tao H, Zhu R, Zhou Z. Serum amyloid A and risks of all-cause and cardiovascular mortality in chronic kidney disease: a systematic review and dose-response meta-analysis. Ren Fail 2023; 45:2250877. [PMID: 37930241 PMCID: PMC10512819 DOI: 10.1080/0886022x.2023.2250877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/17/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUNDS The available literature on the correlation between serum amyloid A (SAA) and prognosis of chronic kidney disease (CKD) are limited, and the findings from existing studies are inconclusive. This meta-analysis aimed to evaluate the available evidence regarding the link between SAA and risks of all-cause and cardiovascular mortality in CKD patients. Additionally, we aimed to investigate the potential dose-response relationships, provided that adequate data is accessible. METHODS Pubmed and Embase were searched for related literature (last update: 12 July 2023). The pooled effect estimates were calculated using random- or fixed-effects models depending on heterogeneity among studies. RESULTS This meta-analysis incorporated 8 studies encompassing 2331 CKD patients. The findings revealed an 85% increase in all-cause mortality risk [hazard risk (HR) 1.85, 95% confidence interval (CI) 1.29-2.65] and a 39% increase in cardiovascular mortality risk (HR 1.07, 95% CI 1.07-1.80) when comparing the highest tertile of baseline SAA levels to the lowest tertile. Furthermore, a positive linear relationship between SAA and all-cause mortality risk was observed (Pnon-linearity = 0.959), with a 17.7% increase in risk for each 10 mg/L SAA increase (HR 1.177, 95% CI 1.055-1.313). Similarly, a linear relationship between SAA and cardiovascular mortality risk was identified (Pnon-linearity = 0.477) with a 19.3% increase in risk for each 10 mg/L SAA increase (HR 1.193, 95% CI 1.025-1.388). CONCLUSIONS This meta-analysis provided evidence that SAA levels are positively and linearly associated with risks of all-cause and cardiovascular mortality among CKD patients.
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Affiliation(s)
- Li Li
- Department of Clinical Laboratory, Binhai County People’s Hospital, Binhai, China
| | - Hongli Liu
- Department of Clinical Laboratory, Nantong Tumor Hospital, Tumor Hospital Affiliated to Nantong University, China
| | - Qinglin Zhang
- Department of Blood Transfusion, Affiliated Hospital 6 of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’s Hospital, Jiangsu, China
| | - Hao Jin
- Department of Blood Transfusion, Affiliated Hospital 6 of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’s Hospital, Jiangsu, China
| | - Hui Tao
- Department of Blood Transfusion, Affiliated Hospital 6 of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’s Hospital, Jiangsu, China
| | - Rong Zhu
- Department of Clinical Laboratory, Affiliated Hospital 6 of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’s Hospital, Yancheng, China
| | - Zhongwei Zhou
- Department of Clinical Laboratory, Affiliated Hospital 6 of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’s Hospital, Yancheng, China
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den Hartigh LJ, May KS, Zhang XS, Chait A, Blaser MJ. Serum amyloid A and metabolic disease: evidence for a critical role in chronic inflammatory conditions. Front Cardiovasc Med 2023; 10:1197432. [PMID: 37396595 PMCID: PMC10311072 DOI: 10.3389/fcvm.2023.1197432] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 07/04/2023] Open
Abstract
Serum amyloid A (SAA) subtypes 1-3 are well-described acute phase reactants that are elevated in acute inflammatory conditions such as infection, tissue injury, and trauma, while SAA4 is constitutively expressed. SAA subtypes also have been implicated as playing roles in chronic metabolic diseases including obesity, diabetes, and cardiovascular disease, and possibly in autoimmune diseases such as systemic lupus erythematosis, rheumatoid arthritis, and inflammatory bowel disease. Distinctions between the expression kinetics of SAA in acute inflammatory responses and chronic disease states suggest the potential for differentiating SAA functions. Although circulating SAA levels can rise up to 1,000-fold during an acute inflammatory event, elevations are more modest (∼5-fold) in chronic metabolic conditions. The majority of acute-phase SAA derives from the liver, while in chronic inflammatory conditions SAA also derives from adipose tissue, the intestine, and elsewhere. In this review, roles for SAA subtypes in chronic metabolic disease states are contrasted to current knowledge about acute phase SAA. Investigations show distinct differences between SAA expression and function in human and animal models of metabolic disease, as well as sexual dimorphism of SAA subtype responses.
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Affiliation(s)
- Laura J. den Hartigh
- Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA, United States
- Diabetes Institute, University of Washington, Seattle, WA, United States
| | - Karolline S. May
- Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA, United States
- Diabetes Institute, University of Washington, Seattle, WA, United States
| | - Xue-Song Zhang
- Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, NJ, United States
| | - Alan Chait
- Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA, United States
- Diabetes Institute, University of Washington, Seattle, WA, United States
| | - Martin J. Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, NJ, United States
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Elloumi N, Bahloul M, Benabdallah E, Kharrat S, Fakhfakh R, Bouchaala K, Abida O, Chtara K, Masmoudi H, Bouaziz M. Genes regulating oxidative-inflammatory response in circulating monocytes and neutrophils in septic syndrome. Biol Futur 2023; 74:199-207. [PMID: 37291472 DOI: 10.1007/s42977-023-00168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/13/2023] [Indexed: 06/10/2023]
Abstract
Despite significant progress in the past decades, sepsis still lacks a specific treatment. Under normal conditions, leucocytes play a critical role in controlling infection and it is suggested that their activity is impaired during sepsis which contribute to the dysregulation of immune reactions. Indeed, in response to infection, several intracellular pathways are affected mainly those regulating the oxidative- inflammatory axis. Herein, we focused on the contribution of NF-kB, iNOS, Nrf2, HO-1 and MPO genes in the pathophysiology of septic syndrome, by analyzing the differential expression of their transcripts in circulating monocytes and neutrophils, and monitoring the nitrosative/oxidative status in septic syndrome patients. Circulating neutrophils of septic patients displayed a significant overexpression of NF-kB compared to other groups. In monocytes, patients with septic shock expressed the highest levels of iNOS and NF-kB mRNA. However, genes involved in cytoprotective response had increased expression in patients with sepsis, in particular, the Nrf2 and its target gene HO-1. Moreover, patient monitoring indicates that the iNOS enzyme expression and NO plasma levels may play a role in assessing the severity of septic conditions. Overall, in either monocytes or neutrophils, we pointed out the major role of NF-κB and Nrf2 in the pathophysiological process. Therefore, therapies targeted to redox abnormalities may be useful for better management of septic patients.
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Affiliation(s)
- Nesrine Elloumi
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia.
| | - Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Emna Benabdallah
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Raouia Fakhfakh
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Karama Bouchaala
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Olfa Abida
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hatem Masmoudi
- Research Laboratory LR18/SP12 Auto-Immunity, Cancer and Immunogenetics, Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3029, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
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KURT F, ERÖZ R, KOCABAY K. Apoptosis-associated speck-like protein containing a CARD (ASC), TNF Like Factor 1a(TL-1a) and B Cell Chemoattractant Chemokine Ligand 13(CXCL-13) expression profiles in familial Mediterranean fever (FMF) patients. KONURALP TIP DERGISI 2023. [DOI: 10.18521/ktd.1162175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: This study was carried out to compare the expression levels of ASC(Apoptosis Associated Speck Like Protein Containing a CARD), TL-1a(TNF Like Factor 1a) and CXCL 13(B Cell Chemoattractant Chemokine Ligand 13) genes in FMF patients According to Tell-Hashomer Criteria and Genetic analysis result in Düzce University Research and Application Hospital with healthy controls and to determine their clinical significance in FMF.
Method: 36 patients (20 girls, 16 boys) and 12 healthy controls (7 girls, 5 boys) were included in the study. RNA was isolated from the peripheral blood of each individual and expression levels of ASC, TL-1a and CXCL 13 genes were determined. Routine biochemical parameters were also determined.
Result: CXCL 13 and TL-1a gene expression levels were significantly increased in patients with FMF, the expression level of the ASC gene was found to be increased in FMF patients, but not significantly.
Conclusion: The expression levels of these genes may be related to the pathogenesis of the disease and these genes could be used as a marker in the early diagnosis of the disease.
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Bulgarelli C, Ciuffoli E, Troia R, Goggs R, Dondi F, Giunti M. Apolipoprotein A1 and serum amyloid A in dogs with sepsis and septic shock. Front Vet Sci 2023; 10:1098322. [PMID: 36937011 PMCID: PMC10019819 DOI: 10.3389/fvets.2023.1098322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Apolipoprotein-A1 (Apo-A1) acts as a negative acute phase protein (APP) during inflammatory states, and has a potential prognostic value in people and dogs with sepsis. The aim of this retrospective study was to investigate the association of serum Apo-A1 concentration with disease severity, multiorgan dysfunction syndrome (MODS) and outcome in a population of dogs with sepsis, and to assess its correlation with major canine APPs. Methods Ninety-nine dogs with uncomplicated sepsis (n = 78) or septic shock (n = 21) were included. The serum concentration of Apo-A1, C-reactive protein (CRP) and serum amyloid A (SAA) were recorded, alongside the canine acute patient physiologic and laboratory evaluation fast (APPLEfast) score and the presence of MODS. Results Dogs with septic shock had significantly lower serum Apo-A1 concentrations (106.3 ± 22.7 mg/dl; reference interval: 123.0-142.3 mg/dl), higher APPLEfast score (30, 13-38) and greater frequency of MODS (67%) compared to those with uncomplicated sepsis (117.9 ± 19.3 mg/dl; 25, 6-33 and 8%, respectively) (P = 0.0201; P = 0.0005; P < 0.0001, respectively). Similarly, dogs with MODS had significantly lower serum Apo-A1 concentrations (104.1 ± 4.6 mg/dl) and higher APPLEfast score values (31, 13-38) compared to those without MODS (118.32 ± 2.1 mg/dl and 26, 6-33, respectively) (P = 0.0050 and P = 0.0038, respectively). Conversely, neither CRP nor SAA were different between these groups. No difference in serum APPs concentrations was detected between survivors and non-survivors. Significant negative correlations were detected between serum Apo-A1 and SAA (P = 0.0056, r = -0.277), and between serum Apo-A1 and the APPLEfast score (P = 0.0027, r = -0.3). In this population, higher values of the APPLEfast score and the presence of MODS were independently associated with a higher risk of death. Discussion Our study shows that Apo-A1 is a useful biomarker of sepsis severity in dogs, since it is decreased in those with septic shock and MODS. Further prospective investigations are deemed to evaluate the applicability of Apo-A1 to predict sepsis course and response to treatment in septic dogs.
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Affiliation(s)
- Cecilia Bulgarelli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Elena Ciuffoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Roberta Troia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
- *Correspondence: Massimo Giunti
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Gases in Sepsis: Novel Mediators and Therapeutic Targets. Int J Mol Sci 2022; 23:ijms23073669. [PMID: 35409029 PMCID: PMC8998565 DOI: 10.3390/ijms23073669] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
Sepsis, a potentially lethal condition resulting from failure to control the initial infection, is associated with a dysregulated host defense response to pathogens and their toxins. Sepsis remains a leading cause of morbidity, mortality and disability worldwide. The pathophysiology of sepsis is very complicated and is not yet fully understood. Worse still, the development of effective therapeutic agents is still an unmet need and a great challenge. Gases, including nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S), are small-molecule biological mediators that are endogenously produced, mainly by enzyme-catalyzed reactions. Accumulating evidence suggests that these gaseous mediators are widely involved in the pathophysiology of sepsis. Many sepsis-associated alterations, such as the elimination of invasive pathogens, the resolution of disorganized inflammation and the preservation of the function of multiple organs and systems, are shaped by them. Increasing attention has been paid to developing therapeutic approaches targeting these molecules for sepsis/septic shock, taking advantage of the multiple actions played by NO, CO and H2S. Several preliminary studies have identified promising therapeutic strategies for gaseous-mediator-based treatments for sepsis. In this review article, we summarize the state-of-the-art knowledge on the pathophysiology of sepsis; the metabolism and physiological function of NO, CO and H2S; the crosstalk among these gaseous mediators; and their crucial effects on the development and progression of sepsis. In addition, we also briefly discuss the prospect of developing therapeutic interventions targeting these gaseous mediators for sepsis.
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Tang Y, Ling N, Li S, Huang J, Zhang W, Zhang A, Ren H, Yang Y, Hu H, Wang X. A panel of urine-derived biomarkers to identify sepsis and distinguish it from systemic inflammatory response syndrome. Sci Rep 2021; 11:20794. [PMID: 34675320 PMCID: PMC8531286 DOI: 10.1038/s41598-021-99595-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Sepsis is a potentially fatal condition caused by infection. It is frequently difficult to distinguish sepsis from systemic inflammatory response syndrome (SIRS), often resulting in poor prognoses and the misuse of antibiotics. Hence, highly sensitive and specific biomarkers are needed to differentiate sepsis from SIRS. Urine samples were collected and segregated by group (a sepsis group, a SIRS group, and a healthy control group). iTRAQ was used to identify the differentially expressed proteins among the three groups. The identified proteins were measured by ELISA in urine samples. Finally, all the acquired data were analyzed in SPSS. C-reactive protein, leucine-rich alpha glycoprotein-1 and serum amyloid A (SAA) protein were differentially expressed among the three groups. The adjusted median concentrations of urinary C-reactive protein were 1337.6, 358.7, and 2.4 in the sepsis, SIRS, and healthy control groups, respectively. The urinary leucine-rich alpha glycoprotein-1 levels in these three groups were 1614.4, 644.5, and 13.6, respectively, and the levels of SAA were 6.3, 2.9, and 0.07, respectively. For all three of these measures, the sepsis group had higher levels than the SIRS group (P < 0.001), and the SIRS group had higher levels than the healthy control group. When combined, the three biomarkers had a sensitivity of 0.906 and a specificity of 0.896 in distinguishing sepsis from SIRS. Urinary C-reactive protein, urinary leucine-rich alpha glycoprotein-1 and urinary SAA have diagnostic value in cases of sepsis. This initial study suggests the possibility of improved differential diagnosis between sepsis and systemic inflammatory response syndrome; additional confirmation is necessary to corroborate the findings.
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Affiliation(s)
- Yao Tang
- Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ning Ling
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Shiying Li
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Juan Huang
- Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Wenyue Zhang
- Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - An Zhang
- Intensive Care Unit, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hong Ren
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yixuan Yang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Huaidong Hu
- Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaohao Wang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
- Department of Clinical Nutrition, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
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Glutathione Reductase Is Associated with the Clinical Outcome of Septic Shock in the Patients Treated Using Continuous Veno-Venous Haemofiltration. ACTA ACUST UNITED AC 2021; 57:medicina57070689. [PMID: 34356970 PMCID: PMC8307392 DOI: 10.3390/medicina57070689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022]
Abstract
Background and objectives: At present, there is insufficient evidence to support the use of continuous veno-venous haemofiltration (CVVH) in the early treatment of septic shock. This study focuses on the association between survival and different parameters of oxidative stress (RedOx). Thereby, we evaluated whether RedOx markers are associated with the outcome of septic shock in patients under early-initiated CVVH treatment. Materials and Methods: We conducted a prospective observational study of 65 patients with septic shock who started CVVH within 12 h after hospital admission. Blood samples were taken from each patient prior to the start of CVVH. The following RedOx markers were measured: glutathione peroxidase, glutathione reductase (GR), total antioxidant capacity, superoxide dismutase, nitric oxide, malondialdehyde and 4-hydroxynonenal. The odds ratio (OR) was calculated using binary logistic regression and stepwise multivariable regression. Results: The 65 patients had a median age of 66 years and 39 were male. Based on the outcome, the patients were divided into two groups—non-survivors (n = 29) and survivors (n = 36)—and the levels of RedOx markers were compared between them. Of all the markers, only higher GR activity was found to be significantly associated with the fatal outcome; 100.3 U/L versus 60.5 U/L, OR = 1.027 (95% CI, 1.010–1.044). Following adjustment for the sequential organ failure assessment score and other parameters, GR activity still presented a significant association with the fatal outcome, OR = 1.020 (95% CI, 1.002–1.038). Conclusions: GR activity is associated with in-hospital fatal outcomes among septic shock patients under early-initiated CVVH treatment. Septic shock patients who have a lower GR activity at hospital admission may have a favourable outcome of the early initiation of CVVH.
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Serum amyloid A in polycystic ovary syndrome. Clin Chim Acta 2021; 518:151-155. [PMID: 33811926 DOI: 10.1016/j.cca.2021.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/21/2021] [Accepted: 03/29/2021] [Indexed: 11/21/2022]
Abstract
Polycystic ovary syndrome (PCOS), i.e., anovulation, hyperandrogenemia and polycystic ovary, is an endocrine-metabolic disease affecting reproductive aged women. Women with PCOS are likely to develop obesity, dyslipidemia, type 2 diabetes mellitus (T2DM) and cardiovascular diseases at a younger age. Despite high frequency and severe disease burden, the pathophysiological mechanisms of PCOS remain poorly defined and correspondingly have no therapeutic options. Emerging evidence has demonstrated that PCOS is accompanied with low-grade chronic inflammation and biomarkers thereof. Interestingly, serum amyloid A (SAA) has recently been identified as a potential marker of infection and inflammation and a number of studies have reported an association with PCOS. In this review, we explore the relationship between SAA and hyperandrogenemia, inflammation, obesity and insulin resistance, and provide convincing evidence for SAA as a potential inflammatory biomarker in PCOS.
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Zhong X, Ma A, Zhang Z, Liu Y, Liang G. Neutrophil-to-lymphocyte ratio as a predictive marker for severe pediatric sepsis. Transl Pediatr 2021; 10:657-665. [PMID: 33880335 PMCID: PMC8041612 DOI: 10.21037/tp-21-47] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although neutrophil-to-lymphocyte ratio (NLR) has been extensively studied in several diseases, its role in pediatric sepsis remains unclear. Our study aimed to assess the predictive significance of NLR for severe pediatric sepsis in the pediatric intensive care unit (PICU). METHODS We retrospectively recruited critically ill children in the PICU with severe pediatric sepsis from January 2019 to January 2020 in West China Hospital of Sichuan University. Univariate and multivariable logistic regression analysis was used to assess the risk factors of severe pediatric sepsis. Receiver operating characteristic (ROC) curves were plotted for the comparison of the prediction significance of NLR. RESULTS Overall, 202 patients (severe sepsis 45; non-severe sepsis 157) were included. In the severe sepsis group, the levels of NLR (P<0.001), procalcitonin (PCT; P<0.001), and the Pediatric Risk of Mortality score (PRISM III) were higher than those in the nonsevere sepsis group (P<0.001). The PICU stay time (P<0.001), mechanical ventilation length (P=0.004), and hospital stay time (P<0.001) in the severe sepsis patients were noticeably more extended than those in the control patients. The area under the ROC curve (AUC) of NLR was 0.715 (P<0.001), which was higher than that of the PRISM III score (AUC =0.651, P<0.001) and PCT (AUC =0.647, P<0.001). Furthermore, the constructed predictive model of NLR + PCT + PRISM III showed a better prediction significance than they alone (AUC =0.888, P<0.001). CONCLUSIONS Results indicated that the initial NLR value was a significant biomarker for predicting severe pediatric sepsis. The combined NLR and PCT improved the evaluation for further early identification of severe sepsis in children.
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Affiliation(s)
- Xi Zhong
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Aijia Ma
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Zhongwei Zhang
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yong Liu
- Department of Gastroenterological Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Guopeng Liang
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
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Clinical Value of Serum Amyloid-A Protein, High-density Lipoprotein Cholesterol and Apolipoprotein-A1 in the Diagnosis and Follow-up of Neonatal Sepsis. Pediatr Infect Dis J 2020; 39:749-755. [PMID: 32251257 DOI: 10.1097/inf.0000000000002682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND To evaluate the performance of serum amyloid-A (SAA), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein-A1 (Apo-A1) levels in the identification and monitoring of neonatal sepsis. METHODS This prospective study included 113 full-term septic neonates (postnatal age 4-28 days) admitted to the Special Care Neonatal Unit of a University Hospital from January 1, 2016, to April 30, 2019, and 68 healthy neonates (controls). Blood samples were drawn serially in septic neonates at enrollment and on days 1, 3 and 7, and once in controls, for SAA, HDL-C and Apo-A1 determination. RESULTS At enrollment, SAA levels were significantly higher in septic neonates in comparison with controls (median 50.7 vs. 3.5 mg/L; P < 0.0001); HDL-C and Apo-A1 levels were significantly lower in patients than in controls (P < 0.001 and P < 0.006, respectively). SAA levels were higher in culture-positive compared with culture-negative sepsis (median 202.0 vs. 14.2 mg/L; P < 0.0001). HDL-C and Apo-A1 levels did not differ significantly between culture-positive and culture-negative sepsis. Receiver operating characteristic curve analysis of SAA levels at enrollment resulted in significant areas under the curve (AUC) for detecting sepsis {AUC = 0.929 [95% confidence interval: 0.885-0.973]; P < 0.0001} and also for discriminating between culture-positive and culture-negative sepsis [AUC = 0.933 (95% confidence interval: 0.882-0.984); P < 0.0001]. The combination of HDL-C and Apo-A1 with SAA increased its diagnostic performance. Furthermore, serial SAA levels following enrollment could indicate clinical response in septic neonates. CONCLUSIONS SAA seems to be a useful biomarker for identification and monitoring of neonatal sepsis, and also for discriminating between culture-positive and culture-negative sepsis. HDL-C and Apo-A1 could be used as complementary markers.
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