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A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis
BACKGROUND: Early prognostic stratification of patients with sepsis is a difficult clinical challenge. Aim of this study was to evaluate novel molecules in association with clinical parameters as predictors of 90-days mortality in patients admitted with sepsis at Humanitas Research Hospital. METHODS...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521428/ https://www.ncbi.nlm.nih.gov/pubmed/36189302 http://dx.doi.org/10.3389/fimmu.2022.979232 |
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author | Davoudian, Sadaf Piovani, Daniele Desai, Antonio Mapelli, Sarah N. Leone, Roberto Sironi, Marina Valentino, Sonia Silva-Gomes, Rita Stravalaci, Matteo Asgari, Fatemeh Madera, Alessandra Piccinini, Daniele Fedeli, Carlo Comina, Denise Bonovas, Stefanos Voza, Antonio Mantovani, Alberto Bottazzi, Barbara |
author_facet | Davoudian, Sadaf Piovani, Daniele Desai, Antonio Mapelli, Sarah N. Leone, Roberto Sironi, Marina Valentino, Sonia Silva-Gomes, Rita Stravalaci, Matteo Asgari, Fatemeh Madera, Alessandra Piccinini, Daniele Fedeli, Carlo Comina, Denise Bonovas, Stefanos Voza, Antonio Mantovani, Alberto Bottazzi, Barbara |
author_sort | Davoudian, Sadaf |
collection | PubMed |
description | BACKGROUND: Early prognostic stratification of patients with sepsis is a difficult clinical challenge. Aim of this study was to evaluate novel molecules in association with clinical parameters as predictors of 90-days mortality in patients admitted with sepsis at Humanitas Research Hospital. METHODS: Plasma samples were collected from 178 patients, diagnosed based on Sepsis-3 criteria, at admission to the Emergency Department and after 5 days of hospitalization. Levels of pentraxin 3 (PTX3), soluble IL-1 type 2 receptor (sIL-1R2), and of a panel of pro- and anti-inflammatory cytokines were measured by ELISA. Cox proportional-hazard models were used to evaluate predictors of 90-days mortality. RESULTS: Circulating levels of PTX3, sIL-1R2, IL-1β, IL-6, IL-8, IL-10, IL-18, IL-1ra, TNF-α increased significantly in sepsis patients on admission, with the highest levels measured in shock patients, and correlated with SOFA score (PTX3: r=0.44, p<0.0001; sIL-1R2: r=0.35, p<0.0001), as well as with 90-days mortality. After 5 days of hospitalization, PTX3 and cytokines, but not sIL-1R2 levels, decreased significantly, in parallel with a general improvement of clinical parameters. The combination of age, blood urea nitrogen, PTX3, IL-6 and IL-18, defined a prognostic index predicting 90-days mortality in Sepsis-3 patients and showing better apparent discrimination capacity than the SOFA score (AUC=0.863, 95% CI: 0.780−0.945 vs. AUC=0.727, 95% CI: 0.613-0.840; p=0.021 respectively). CONCLUSION: These data suggest that a prognostic index based on selected cytokines, PTX3 and clinical parameters, and hence easily adoptable in clinical practice, performs in predicting 90-days mortality better than SOFA. An independent validation is required. |
format | Online Article Text |
id | pubmed-9521428 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95214282022-09-30 A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis Davoudian, Sadaf Piovani, Daniele Desai, Antonio Mapelli, Sarah N. Leone, Roberto Sironi, Marina Valentino, Sonia Silva-Gomes, Rita Stravalaci, Matteo Asgari, Fatemeh Madera, Alessandra Piccinini, Daniele Fedeli, Carlo Comina, Denise Bonovas, Stefanos Voza, Antonio Mantovani, Alberto Bottazzi, Barbara Front Immunol Immunology BACKGROUND: Early prognostic stratification of patients with sepsis is a difficult clinical challenge. Aim of this study was to evaluate novel molecules in association with clinical parameters as predictors of 90-days mortality in patients admitted with sepsis at Humanitas Research Hospital. METHODS: Plasma samples were collected from 178 patients, diagnosed based on Sepsis-3 criteria, at admission to the Emergency Department and after 5 days of hospitalization. Levels of pentraxin 3 (PTX3), soluble IL-1 type 2 receptor (sIL-1R2), and of a panel of pro- and anti-inflammatory cytokines were measured by ELISA. Cox proportional-hazard models were used to evaluate predictors of 90-days mortality. RESULTS: Circulating levels of PTX3, sIL-1R2, IL-1β, IL-6, IL-8, IL-10, IL-18, IL-1ra, TNF-α increased significantly in sepsis patients on admission, with the highest levels measured in shock patients, and correlated with SOFA score (PTX3: r=0.44, p<0.0001; sIL-1R2: r=0.35, p<0.0001), as well as with 90-days mortality. After 5 days of hospitalization, PTX3 and cytokines, but not sIL-1R2 levels, decreased significantly, in parallel with a general improvement of clinical parameters. The combination of age, blood urea nitrogen, PTX3, IL-6 and IL-18, defined a prognostic index predicting 90-days mortality in Sepsis-3 patients and showing better apparent discrimination capacity than the SOFA score (AUC=0.863, 95% CI: 0.780−0.945 vs. AUC=0.727, 95% CI: 0.613-0.840; p=0.021 respectively). CONCLUSION: These data suggest that a prognostic index based on selected cytokines, PTX3 and clinical parameters, and hence easily adoptable in clinical practice, performs in predicting 90-days mortality better than SOFA. An independent validation is required. Frontiers Media S.A. 2022-09-15 /pmc/articles/PMC9521428/ /pubmed/36189302 http://dx.doi.org/10.3389/fimmu.2022.979232 Text en Copyright © 2022 Davoudian, Piovani, Desai, Mapelli, Leone, Sironi, Valentino, Silva-Gomes, Stravalaci, Asgari, Madera, Piccinini, Fedeli, Comina, Bonovas, Voza, Mantovani and Bottazzi https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Davoudian, Sadaf Piovani, Daniele Desai, Antonio Mapelli, Sarah N. Leone, Roberto Sironi, Marina Valentino, Sonia Silva-Gomes, Rita Stravalaci, Matteo Asgari, Fatemeh Madera, Alessandra Piccinini, Daniele Fedeli, Carlo Comina, Denise Bonovas, Stefanos Voza, Antonio Mantovani, Alberto Bottazzi, Barbara A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis |
title | A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis |
title_full | A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis |
title_fullStr | A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis |
title_full_unstemmed | A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis |
title_short | A cytokine/PTX3 prognostic index as a predictor of mortality in sepsis |
title_sort | cytokine/ptx3 prognostic index as a predictor of mortality in sepsis |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521428/ https://www.ncbi.nlm.nih.gov/pubmed/36189302 http://dx.doi.org/10.3389/fimmu.2022.979232 |
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