Zoltán Horváth-Szalai1, Péter Kustán2, Diána Mühl3, Andrea Ludány1, Beáta Bugyi4, Tamás Kőszegi5. 1. Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary. 2. Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Department of Anaesthesiology and Intensive Therapy, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary. 3. Department of Anaesthesiology and Intensive Therapy, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary. 4. Department of Biophysics, University of Pécs, 7624 Pécs, Szigeti út 12, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary. 5. Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary. Electronic address: tamas.koszegi@aok.pte.hu.
Abstract
OBJECTIVES: For appropriate sepsis care, prognostic laboratory markers are mandatory. The aim of our study was to evaluate the predictive value of serum actin, gelsolin and the recently defined actin/gelsolin ratio during sepsis by comparison it to classical clinical and inflammatory laboratory parameters. DESIGN & METHODS: We analyzed sera of severe septic (n=32) and SIRS (n=12) patients for 5days. Ophthalmologic patients (n=27) served as controls. Besides serum actin, gelsolin and actin/gelsolin ratios classical laboratory parameters (WBC count, serum procalcitonin, hsCRP) and clinical scores (APACHE II, SAPS II, SOFA), were also assessed. RESULTS: Septic patients showed significantly decreased first-day gelsolin levels and increased actin/gelsolin ratios compared to SIRS patients (p<0.05), furthermore, non-survivors had significantly lower gelsolin levels compared to survivors (p<0.05). Non-survivors had 11.4-fold higher 2nd day actin/gelsolin ratios than survivors. Besides procalcitonin (PCT) and hsCRP, gelsolin and actin/gelsolin ratios also proved to be useful in discriminating SIRS from sepsis in the ICU (p<0.05). Gelsolin had similar prognostic value to PCT when assessing 7-day mortality and the predictive capacity of the first-day actin/gelsolin ratios was similar to that of APACHE II score regarding ICU mortality in severe sepsis. CONCLUSIONS: Serum gelsolin and actin/gelsolin ratio might serve as efficient complementary prognostic markers in sepsis. However, for daily clinical usage, an automated laboratory assay of actin and gelsolin is still needed to be developed.
OBJECTIVES: For appropriate sepsis care, prognostic laboratory markers are mandatory. The aim of our study was to evaluate the predictive value of serum actin, gelsolin and the recently defined actin/gelsolin ratio during sepsis by comparison it to classical clinical and inflammatory laboratory parameters. DESIGN & METHODS: We analyzed sera of severe septic (n=32) and SIRS (n=12) patients for 5days. Ophthalmologic patients (n=27) served as controls. Besides serum actin, gelsolin and actin/gelsolin ratios classical laboratory parameters (WBC count, serum procalcitonin, hsCRP) and clinical scores (APACHE II, SAPS II, SOFA), were also assessed. RESULTS: Septic patients showed significantly decreased first-day gelsolin levels and increased actin/gelsolin ratios compared to SIRS patients (p<0.05), furthermore, non-survivors had significantly lower gelsolin levels compared to survivors (p<0.05). Non-survivors had 11.4-fold higher 2nd day actin/gelsolin ratios than survivors. Besides procalcitonin (PCT) and hsCRP, gelsolin and actin/gelsolin ratios also proved to be useful in discriminating SIRS from sepsis in the ICU (p<0.05). Gelsolin had similar prognostic value to PCT when assessing 7-day mortality and the predictive capacity of the first-day actin/gelsolin ratios was similar to that of APACHE II score regarding ICU mortality in severe sepsis. CONCLUSIONS: Serum gelsolin and actin/gelsolin ratio might serve as efficient complementary prognostic markers in sepsis. However, for daily clinical usage, an automated laboratory assay of actin and gelsolin is still needed to be developed.
Authors: Zoltán Horváth-Szalai; Péter Kustán; Balázs Szirmay; Ágnes Lakatos; Per H Christensen; Tamás Huber; Beáta Bugyi; Diána Mühl; Andrea Ludány; Attila Miseta; Gábor L Kovács; Tamás Kőszegi Journal: J Clin Lab Anal Date: 2017-09-05 Impact factor: 2.352
Authors: J Wittmann; J Dieckow; H Schröder; U Hampel; F Garreis; C Jacobi; A Milczarek; K L Hsieh; B Pulli; J W Chen; S Hoogeboom; L Bräuer; F P Paulsen; S Schob; M Schicht Journal: Sci Rep Date: 2018-09-03 Impact factor: 4.379