BACKGROUND: The identification of highly reliable outcome predictors in severe sepsis is important to define disease severity, predict bedside prognosis and monitor response to treatment. Cell-free plasma DNA (cfDNA) has been recently proposed as a possible prognostic marker of clinical outcome in septic patients. In this study, we investigated the prognostic value of cfDNA in patients with sepsis and its possible correlation with caspase-3, IL-6 and IL-18 levels. METHODS: We enrolled 34 patients admitted to the intensive care unit (ICU). Out of these 34, 27 patients were septic and 7 were non-septic. cfDNA was extracted from plasma and quantified by real time PCR. Plasma levels of caspase-3, IL-6 and IL-18 were measured by ELISA. RESULTS: We observed significantly higher levels of cfDNA in septic patients. No significant differences were found between cfDNA levels in patients with Gram+, Gram- and fungal infections. Out of the 27 septic patients, 12 developed acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT), and cfDNA levels resulted to be higher in this group. Out of the 27 septic patients, 11 had a negative outcome during the ICU stay. The cfDNA concentrations at admission were higher in non-survivors than in survivors. Caspase-3, IL-6 and IL-18 levels were significantly higher in septic patients when compared to these levels in non-septic patients and correlated with cfDNA levels. CONCLUSION: cfDNA can be considered a good prognostic marker of clinical outcome in septic patients. Its levels increase in case of AKI complicating sepsis, in particular if CRRT is needed, and are associated with poor outcome. Caspase-3, IL-6 and IL-18 levels are higher in septic patients and correlate to cfDNA concentrations.
BACKGROUND: The identification of highly reliable outcome predictors in severe sepsis is important to define disease severity, predict bedside prognosis and monitor response to treatment. Cell-free plasma DNA (cfDNA) has been recently proposed as a possible prognostic marker of clinical outcome in septic patients. In this study, we investigated the prognostic value of cfDNA in patients with sepsis and its possible correlation with caspase-3, IL-6 and IL-18 levels. METHODS: We enrolled 34 patients admitted to the intensive care unit (ICU). Out of these 34, 27 patients were septic and 7 were non-septic. cfDNA was extracted from plasma and quantified by real time PCR. Plasma levels of caspase-3, IL-6 and IL-18 were measured by ELISA. RESULTS: We observed significantly higher levels of cfDNA in septic patients. No significant differences were found between cfDNA levels in patients with Gram+, Gram- and fungal infections. Out of the 27 septic patients, 12 developed acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT), and cfDNA levels resulted to be higher in this group. Out of the 27 septic patients, 11 had a negative outcome during the ICU stay. The cfDNA concentrations at admission were higher in non-survivors than in survivors. Caspase-3, IL-6 and IL-18 levels were significantly higher in septic patients when compared to these levels in non-septic patients and correlated with cfDNA levels. CONCLUSION: cfDNA can be considered a good prognostic marker of clinical outcome in septic patients. Its levels increase in case of AKI complicating sepsis, in particular if CRRT is needed, and are associated with poor outcome. Caspase-3, IL-6 and IL-18 levels are higher in septic patients and correlate to cfDNA concentrations.
Authors: Ľ Janovičová; B Gromová; D Drobná; B Konečná; E Renczés; V Borbélyová; J Hodosy; P Celec Journal: Physiol Res Date: 2021-10-30 Impact factor: 1.881
Authors: L Lorente; M M Martín; A Pérez-Cejas; A F González-Rivero; R O López; J Ferreres; J Solé-Violán; L Labarta; C Díaz; S Palmero; A Jiménez Journal: Eur J Clin Microbiol Infect Dis Date: 2017-11-08 Impact factor: 3.267
Authors: Jeroen G H P Verhoeven; Dennis A Hesselink; Annemiek M A Peeters; Evert de Jonge; Jan H von der Thüsen; Ron H N van Schaik; Maja Matic; Carla C Baan; O C Manintveld; Karin Boer Journal: Transpl Int Date: 2022-03-21 Impact factor: 3.782
Authors: Jennifer Ann Klowak; Salhab El Helou; Jeffrey M Pernica; Melissa J Parker; Michael Surette; Hendrik Poinar; Alison E Fox-Robichaud Journal: BMJ Paediatr Open Date: 2020-04-06
Authors: Christopher Duplessis; Michael Gregory; Kenneth Frey; Matthew Bell; Luu Truong; Kevin Schully; James Lawler; Raymond J Langley; Stephen F Kingsmore; Christopher W Woods; Emanuel P Rivers; Anja K Jaehne; Eugenia B Quackenbush; Vance G Fowler; Ephraim L Tsalik; Danielle Clark Journal: J Intensive Care Date: 2018-11-13
Authors: Ruben Van Paemel; Roos Vlug; Katleen De Preter; Nadine Van Roy; Frank Speleman; Leen Willems; Tim Lammens; Geneviève Laureys; Gudrun Schleiermacher; Godelieve A M Tytgat; Kathy Astrahantseff; Hedwig Deubzer; Bram De Wilde Journal: Eur J Pediatr Date: 2020-01-03 Impact factor: 3.183