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Mokhtar WA, Sherief LM, Kamal NM, ElSheikh AO, Omran FH, Abdulsaboor A, Sakr MM, El Gebally S, Shehab MMM, Alfaifi J, Turkistani R, Aljuaid F, Oshi MA, Elbekoushi FB, Mokhtar GA. Late onset neonatal sepsis: Can plasma gelsolin be a promising diagnostic marker? Medicine (Baltimore) 2024; 103:e37356. [PMID: 38457556 PMCID: PMC10919505 DOI: 10.1097/md.0000000000037356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 03/10/2024] Open
Abstract
Plasma gelsolin (pGSN) correlates with clinical improvement in septic patients. We aimed to investigate pGSN levels as a diagnostic and prognostic marker of neonatal late-onset-sepsis (LOS). A case-control study was done on 184 neonates (92 with LOS and 92 controls). All participants were subjected to detailed history taking, full clinical evaluation, sepsis workup, and pGSN enzyme-linked immunosorbent-assay measurement. We detected significantly lower pGSN level among cases compared to controls (90.63 ± 20.64 vs 451.83 ± 209.59). It was significantly related to the severity of sepsis and mortality, with significantly lower values among cases with septic shock and multiorgan failure and non-survivors. Follow-up pGSN significantly increased after sepsis improvement in survivors compared to admission values. pGSN might be a reliable diagnostic and prognostic marker for LOS.
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Affiliation(s)
- Wesam A. Mokhtar
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Laila M. Sherief
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Naglaa M. Kamal
- Pediatric Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Azza O. ElSheikh
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Farida H. Omran
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Abdulsaboor
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Maha M.H. Sakr
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shreif El Gebally
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Jaber Alfaifi
- Department of Child Health, Faculty of Medicine, University of Bisha, Bisha, Kingdom of Saudi Arabia
| | - Reem Turkistani
- Pediatric Department, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Futun Aljuaid
- Pediatric Department, Taif Children Hospital, Taif, Kingdom of Saudi Arabia
| | - Mohammed A.M. Oshi
- Neurology Division, Pediatric Department, Gaafar Ibnauf Children’s Emergency Hospital, Khartoum, Sudan
| | | | - Ghada A. Mokhtar
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Boicean LC, Birlutiu RM, Birlutiu V. Correlations between serum leptin levels and classical biomarkers in SARS-CoV-2 infection, in critically ill patients. Microb Pathog 2023; 182:106238. [PMID: 37419217 DOI: 10.1016/j.micpath.2023.106238] [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: 11/03/2021] [Revised: 04/30/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Altered levels of some blood markers might be linked with the degree of severity and mortality of patients with SARS-CoV-2 infection. This study aimed to find out if there are correlations between serum leptin levels and classical biomarkers. MATERIALS AND METHODS We present a single-center observational cohort study on SARS-CoV-2 infected patients. The study was conducted at Infectious Diseases Clinic of Academic Emergency Hospital Sibiu, from May through November 2020. In this study, we retrospectively analyzed 54 patients, all with confirmed SARS-CoV-2 infection. RESULTS Our results revealed that there is a negative correlation between serum leptin and Interleukin-6 levels and a positive correlation between serum leptin and blood glucose levels. A positive correlation between ferritin and lactate dehydrogenase levels was also observed. No correlation was found between leptin and other biomarkers such as ferritin, neutrophil/lymphocyte ratio, lactate dehydrogenase, C-reactive protein, fibrinogen, erythrocyte sedimentation rate, or D-dimer. CONCLUSIONS Further studies need to be conducted to investigate the role of leptin in SARS-CoV-2 infection. The results of this research could contribute to the introduction of the determination of serum leptin levels in the routine evaluation of patients with critical illness.
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Affiliation(s)
- Loredana Camelia Boicean
- "Lucian Blaga" University of Sibiu, Faculty of Medicine, Sibiu, Romania; Academic Emergency Hospital Sibiu, Infectious Diseases Clinic, Sibiu, Romania.
| | | | - Victoria Birlutiu
- "Lucian Blaga" University of Sibiu, Faculty of Medicine, Sibiu, Romania; Academic Emergency Hospital Sibiu, Infectious Diseases Clinic, Sibiu, Romania
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Kumar V. T cells and their immunometabolism: A novel way to understanding sepsis immunopathogenesis and future therapeutics. Eur J Cell Biol 2018; 97:379-392. [PMID: 29773345 DOI: 10.1016/j.ejcb.2018.05.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/03/2018] [Accepted: 05/03/2018] [Indexed: 02/08/2023] Open
Abstract
Sepsis has always been considered as a big challenge for pharmaceutical companies in terms of discovering and designing new therapeutics. The pathogenesis of sepsis involves aberrant activation of innate immune cells (i.e. macrophages, neutrophils etc.) at early stages. However, a stage of immunosuppression is also observed during sepsis even in the patients who have recovered from it. This stage of immunosuppression is observed due to the loss of conventional (i.e. CD4+, CD8+) T cells, Th17 cells and an upregulation of regulatory T cells (Tregs). This process also impacts metabolic processes controlling immune cell metabolism called immunometabolism. The present review is focused on the T cell-mediated immune response, their immunometabolism and targeting T cell immunometabolism during sepsis as future therapeutic approach. The first part of the manuscripts describes an impact of sepsis on conventional T cells, Th17 cells and Tregs along with their impact on sepsis. The subsequent section further describes the immunometabolism of these cells (CD4+, CD8+, Th17, and Tregs) under normal conditions and during sepsis-induced immunosuppression. The article ends with the therapeutic targeting of T cell immunometabolism (both conventional T cells and Tregs) during sepsis as a future immunomodulatory approach for its management.
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Affiliation(s)
- V Kumar
- Children's Health Queensland Clinical Unit, School of Clinical Medicine, Mater Research, Faculty of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland 4078, Australia; School of Biomedical Sciences, Faculty of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland 4078, Australia.
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Gheorghiţă V, Barbu AE, Gheorghiu ML, Căruntu FA. Endocrine dysfunction in sepsis: a beneficial or deleterious host response? Germs 2015; 5:17-25. [PMID: 25763364 DOI: 10.11599/germs.2015.1067] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 02/28/2015] [Accepted: 03/01/2015] [Indexed: 12/29/2022]
Abstract
Sepsis is a systemic, deleterious inflammatory host response triggered by an infective agent leading to severe sepsis, septic shock and multi-organ failure. The host response to infection involves a complex, organized and coherent interaction between immune, autonomic, neuroendocrine and behavioral systems. Recent data have confirmed that disturbances of the autonomic nervous and neuroendocrine systems could contribute to sepsis-induced organ dysfunction. Through this review, we aimed to summarize the current knowledge about the endocrine dysfunction as response to sepsis, specifically addressed to vasopressin, copeptin, cortisol, insulin and leptin. We searched the following readily accessible, clinically relevant databases: PubMed, UpToDate, BioMed Central. The immune system could be regarded as a "diffuse sensory organ" that signals the presence of pathogens to the brain through different pathways, such as the vagus nerve, endothelial activation/dysfunction, cytokines and neurotoxic mediators and the circumventricular organs, especially the neurohypophysis. The hormonal profile changes substantially as a consequence of inflammatory mediators and microorganism products leading to inappropriately low levels of vasopressin, sick euthyroid syndrome, reduced adrenal responsiveness to ACTH, insulin resistance, hyperglycemia as well as hyperleptinemia. In conclusion, clinical diagnosis of this "pan-endocrine illness" is frequently challenging due to the many limiting factors. The most important benefits of endocrine markers in the management of sepsis may be reflected by their potential to be used as biomarkers in different scoring systems to estimate the severity of the disease and the risk of death.
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Affiliation(s)
- Valeriu Gheorghiţă
- MD, PhD, Dr Carol Davila Central Universitary Emergency Military Hospital, Bucharest, Romania; National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania
| | - Alina Elena Barbu
- MD, National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania
| | - Monica Livia Gheorghiu
- MD, PhD, Lecturer, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Florin Alexandru Căruntu
- MD, PhD, Associate Professor, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania
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Al-Fadhli MA, Saraya MA, Qasem JA. Evaluation of leptin, interleukin-1 beta and tumor necrosis factor alpha in serum of malaria patients as prognostic markers of treatment outcome. Asian Pac J Trop Biomed 2014; 4:441-5. [PMID: 25182944 DOI: 10.12980/apjtb.4.201414b11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/27/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To analyze serum leptin levels in patients with malaria falciparum and compare them with healthy controls and correlate with development and outcome of malaria infection. METHODS Sixty cases of malaria falciparum were included in this study as patients. Thirty healthy individuals of comparable age, racial and body mass index were taken as controls. All patients were diagnosed by clinical picture and the presence of malaria parasites in blood film. Estimation of liver function test, kidney function test, complete blood count, fasting blood sugar, fasting serum insulin, pro-inflammatory cytokine tumor necrosis factor alpha (TNFα) and interleukin 1 (IL1), estimation of morning serum leptin and calculation of body mass index (kg/m(2)) were done in both groups on the day of admission, on discharge and 7 d after discharge. RESULTS At admission, leptin levels were significantly higher in patients group than in control while fasting serum insulin levels were not significantly different between the two groups. There were significant increases as regard to TNFα and IL1 in malaria patients. Significant differences were observed between the control and the patient group for leptin, TNFα and IL1 at the time of admission and discharge. After discharge for 7 d, a significant decline in serum leptin levels, TNFα and IL1 in the patients group was observed as compared with time of admission and time of discharge, a positive correlation between serum leptin levels and TNFα and IL1. CONCLUSIONS Leptin hormone level might play an important role in development and outcome of malaria infection.
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Affiliation(s)
| | - Mohammad Ahmed Saraya
- Department of Medicine, Infectious Disease Hospital, Ministry of Health, Kuwait ; Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Jafar Abdulrida Qasem
- Department of Applied Medical Sciences, College of Health Sciences, Public authority for Applied Education and Training, Kuwait
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Chen M, Wang B, Xu Y, Deng Z, Xue H, Wang L, He L. Diagnostic value of serum leptin and a promising novel diagnostic model for sepsis. Exp Ther Med 2014; 7:881-886. [PMID: 24669245 PMCID: PMC3961119 DOI: 10.3892/etm.2014.1506] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 01/03/2014] [Indexed: 12/20/2022] Open
Abstract
Diagnosis of sepsis in critically ill patients is important to reduce morbidity and mortality. The present study was conducted to determine the role of serum leptin in the early diagnosis of sepsis and to establish a diagnostic model for sepsis. A retrospective study was conducted of 331 patients from an intensive care unit. All patients underwent consistent blood collection at 6:00 a.m. every morning after fasting. Serum leptin concentrations and additional markers of sepsis were compared between the sepsis group (n=128) and the non-sepsis group (n=203). Septic patients displayed significantly higher leptin serum concentrations compared with those of the non-sepsis group (mean concentration, 11.67 versus 4.824 mg/dl; P<0.001). The leptin levels in male patients were higher than those in female patients, particularly in the sepsis group. The accuracy of serum leptin levels in distinguishing septic patients from non-septic patients was 76%, and the area under the receiver operating characteristic (ROC) curve of serum leptin was ≤0.8. Additional markers of inflammation in the sepsis group were also significantly higher than those in the non-sepsis group. Positive correlations were identified between leptin and body temperature, heart rate and creatinine levels. Therefore, a prognostic model comprising a combination of leptin with temperature, platelet count, white blood cell count and heart rate was evaluated as an effective logistic regression model for the diagnosis of sepsis. The logistic regression output cut-off value was 0.46 and the area under the ROC curve was 0.953 (P<0.0001). It may be concluded that leptin is a valuable marker in the diagnosis of sepsis and the proposed prognostic model is an effective logistic regression model for the diagnosis of sepsis. The prognostic model is able to aid the differentiation of septic patients from non-septic patients.
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Affiliation(s)
- Mingyi Chen
- Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Bin Wang
- Department of Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Yaping Xu
- Center of Inspection of Clinical Division, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Zihui Deng
- Research Laboratory of Biochemistry, Basic Medical Institute, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Hui Xue
- Research Laboratory of Biochemistry, Basic Medical Institute, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Luhuan Wang
- Research Laboratory of Biochemistry, Basic Medical Institute, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Lei He
- Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China
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