Stephen P J Macdonald1,2,3, Erika Bosio4,5, Claire Neil4,5, Glenn Arendts4,5,6, Sally Burrows7, Lisa Smart4,5, Simon G A Brown4,5,6, Daniel M Fatovich4,5,6. 1. Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research Perth, Royal Perth Hospital, GPO Box X2213, Perth, WA 6001, Australia. Stephen.macdonald@uwa.edu.au. 2. Discipline of Emergency Medicine, University of Western Australia, Perth, WA, Australia. Stephen.macdonald@uwa.edu.au. 3. Emergency Department, Royal Perth Hospital, Perth, WA, Australia. Stephen.macdonald@uwa.edu.au. 4. Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research Perth, Royal Perth Hospital, GPO Box X2213, Perth, WA 6001, Australia. 5. Discipline of Emergency Medicine, University of Western Australia, Perth, WA, Australia. 6. Emergency Department, Royal Perth Hospital, Perth, WA, Australia. 7. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
Abstract
OBJECTIVE AND DESIGN: Resistin and neutrophil gelatinase-associated lipocalin (NGAL) are upregulated in circulating leucocytes in sepsis, but the significance of this is uncertain. We evaluated associations between Resistin and NGAL with endothelial cell activation and clinical outcomes in a prospective observational study in the Emergency Department (ED). METHODS: Serum levels of Resistin, NGAL, inflammatory cytokines (IL-6, IL-10) and soluble endothelial adhesion molecules (VCAM-1, ICAM-1) were measured at defined time points up to 24 h. Patterns and relationships between markers were investigated using linear mixed regression models. Predictive values for clinical outcomes for markers at enrollment were assessed by logistic regression and receiver operator characteristic (ROC) curves. RESULTS: 186 participants (89 septic-shock, 69 sepsis, 28 uncomplicated infection) were compared with 29 healthy controls. Median Resistin and NGAL were higher in uncomplicated infection compared to controls, and in septic shock compared to non-shock sepsis. Resistin and NGAL correlated with IL-6 and IL-10, with VCAM-1 and ICAM-1, and with organ failure. Resistin and NGAL were associated with septic shock but had limited predictive utility for mortality. CONCLUSION: Resistin and NGAL correlate with expression of endothelial cell adhesion molecules in sepsis. Further evaluation of the role of Resistin and NGAL in sepsis pathogenesis is warranted.
OBJECTIVE AND DESIGN:Resistin and neutrophil gelatinase-associated lipocalin (NGAL) are upregulated in circulating leucocytes in sepsis, but the significance of this is uncertain. We evaluated associations between Resistin and NGAL with endothelial cell activation and clinical outcomes in a prospective observational study in the Emergency Department (ED). METHODS: Serum levels of Resistin, NGAL, inflammatory cytokines (IL-6, IL-10) and soluble endothelial adhesion molecules (VCAM-1, ICAM-1) were measured at defined time points up to 24 h. Patterns and relationships between markers were investigated using linear mixed regression models. Predictive values for clinical outcomes for markers at enrollment were assessed by logistic regression and receiver operator characteristic (ROC) curves. RESULTS: 186 participants (89 septic-shock, 69 sepsis, 28 uncomplicated infection) were compared with 29 healthy controls. Median Resistin and NGAL were higher in uncomplicated infection compared to controls, and in septic shock compared to non-shock sepsis. Resistin and NGAL correlated with IL-6 and IL-10, with VCAM-1 and ICAM-1, and with organ failure. Resistin and NGAL were associated with septic shock but had limited predictive utility for mortality. CONCLUSION:Resistin and NGAL correlate with expression of endothelial cell adhesion molecules in sepsis. Further evaluation of the role of Resistin and NGAL in sepsis pathogenesis is warranted.
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