Levels of endothelial and platelet microparticles and their interactions with leukocytes negatively correlate with organ dysfunction and predict mortality in severe sepsis

Andres O. Soriano, Wenche Jy, Julio A. Chirinos, Martin A. Valdivia, Hermes S. Velasquez, Joaquin J Jimenez, Lawrence L. Horstman, Daniel H Kett, Roland Schein, Yeon Ahn

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Objective: Mortality in sepsis is believed to be associated with exaggerated inflammatory responses, but recent evidence suggests that poor outcome is associated with reduced inflammation. To test this hypothesis, we measured several inflammatory markers to determine whether any of them or any combinations are associated with mortality or organ dysfunction. Design: Clinical study. Setting: School of medicine. Patients: Thirty-five patients with severe sepsis. Interventions: Markers of endothelial, platelet, and leukocyte activation were measured on days 1, 2, and 3 after enrollment. The markers were a) endothelial microparticles (EMPs) and their conjugates with monocytes (EMP/MONO); b) platelet microparticles (PMPs) and platelet activation marker CD62P; c) platelet-leukocyte conjugates (PLT/LEU) and leukocyte activation marker CD11b; and d) intracellular nitric oxide in leukocytes. Measurements and Main Results: The 28-day mortality rate was 51% (18 of 35). Significant differences between survivors and non-survivors on day 1 were found in PLT/LEU (p = .001), CD11b (p = 0.02), and EMP/MONO (p = .02) groups. Using logistic regression to assess if these markers predict mortality on day 1, we found that PLT/LEU had the best predictive value among the markers used (area under receiver operating characteristics curve = 0.82). All markers of cell activation and inflammation were significantly higher among survivors on days 2 and 3, except nitric oxide, which was lower. This marker showed significant negative correlation with the Sequential Organ Failure Assessment score throughout the study. Conclusions: Our data support the hypothesis that early increased, not decreased, inflammatory response as measured by our markers is associated with improved survival rate. A high negative correlation was found between some of these markers and Sequential Organ Failure Assessment score.

Original languageEnglish
Pages (from-to)2540-2546
Number of pages7
JournalCritical Care Medicine
Volume33
Issue number11
DOIs
StatePublished - Nov 1 2005

Fingerprint

Sepsis
Leukocytes
Blood Platelets
Mortality
Organ Dysfunction Scores
Platelet Activation
Survivors
Nitric Oxide
Inflammation
ROC Curve
Monocytes
Survival Rate
Logistic Models
Medicine

Keywords

  • Endothelial activation
  • Endothelial microparticles
  • Nitric oxide
  • Platelet activation
  • Platelet-leukocyte interaction
  • Sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Levels of endothelial and platelet microparticles and their interactions with leukocytes negatively correlate with organ dysfunction and predict mortality in severe sepsis. / Soriano, Andres O.; Jy, Wenche; Chirinos, Julio A.; Valdivia, Martin A.; Velasquez, Hermes S.; Jimenez, Joaquin J; Horstman, Lawrence L.; Kett, Daniel H; Schein, Roland; Ahn, Yeon.

In: Critical Care Medicine, Vol. 33, No. 11, 01.11.2005, p. 2540-2546.

Research output: Contribution to journalArticle

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T1 - Levels of endothelial and platelet microparticles and their interactions with leukocytes negatively correlate with organ dysfunction and predict mortality in severe sepsis

AU - Soriano, Andres O.

AU - Jy, Wenche

AU - Chirinos, Julio A.

AU - Valdivia, Martin A.

AU - Velasquez, Hermes S.

AU - Jimenez, Joaquin J

AU - Horstman, Lawrence L.

AU - Kett, Daniel H

AU - Schein, Roland

AU - Ahn, Yeon

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N2 - Objective: Mortality in sepsis is believed to be associated with exaggerated inflammatory responses, but recent evidence suggests that poor outcome is associated with reduced inflammation. To test this hypothesis, we measured several inflammatory markers to determine whether any of them or any combinations are associated with mortality or organ dysfunction. Design: Clinical study. Setting: School of medicine. Patients: Thirty-five patients with severe sepsis. Interventions: Markers of endothelial, platelet, and leukocyte activation were measured on days 1, 2, and 3 after enrollment. The markers were a) endothelial microparticles (EMPs) and their conjugates with monocytes (EMP/MONO); b) platelet microparticles (PMPs) and platelet activation marker CD62P; c) platelet-leukocyte conjugates (PLT/LEU) and leukocyte activation marker CD11b; and d) intracellular nitric oxide in leukocytes. Measurements and Main Results: The 28-day mortality rate was 51% (18 of 35). Significant differences between survivors and non-survivors on day 1 were found in PLT/LEU (p = .001), CD11b (p = 0.02), and EMP/MONO (p = .02) groups. Using logistic regression to assess if these markers predict mortality on day 1, we found that PLT/LEU had the best predictive value among the markers used (area under receiver operating characteristics curve = 0.82). All markers of cell activation and inflammation were significantly higher among survivors on days 2 and 3, except nitric oxide, which was lower. This marker showed significant negative correlation with the Sequential Organ Failure Assessment score throughout the study. Conclusions: Our data support the hypothesis that early increased, not decreased, inflammatory response as measured by our markers is associated with improved survival rate. A high negative correlation was found between some of these markers and Sequential Organ Failure Assessment score.

AB - Objective: Mortality in sepsis is believed to be associated with exaggerated inflammatory responses, but recent evidence suggests that poor outcome is associated with reduced inflammation. To test this hypothesis, we measured several inflammatory markers to determine whether any of them or any combinations are associated with mortality or organ dysfunction. Design: Clinical study. Setting: School of medicine. Patients: Thirty-five patients with severe sepsis. Interventions: Markers of endothelial, platelet, and leukocyte activation were measured on days 1, 2, and 3 after enrollment. The markers were a) endothelial microparticles (EMPs) and their conjugates with monocytes (EMP/MONO); b) platelet microparticles (PMPs) and platelet activation marker CD62P; c) platelet-leukocyte conjugates (PLT/LEU) and leukocyte activation marker CD11b; and d) intracellular nitric oxide in leukocytes. Measurements and Main Results: The 28-day mortality rate was 51% (18 of 35). Significant differences between survivors and non-survivors on day 1 were found in PLT/LEU (p = .001), CD11b (p = 0.02), and EMP/MONO (p = .02) groups. Using logistic regression to assess if these markers predict mortality on day 1, we found that PLT/LEU had the best predictive value among the markers used (area under receiver operating characteristics curve = 0.82). All markers of cell activation and inflammation were significantly higher among survivors on days 2 and 3, except nitric oxide, which was lower. This marker showed significant negative correlation with the Sequential Organ Failure Assessment score throughout the study. Conclusions: Our data support the hypothesis that early increased, not decreased, inflammatory response as measured by our markers is associated with improved survival rate. A high negative correlation was found between some of these markers and Sequential Organ Failure Assessment score.

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KW - Sepsis

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