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Soluble ST2 plasma concentrations predict mortality in severe sepsis.

Hoogerwerf JJ, Tanck MW, van Zoelen MA, Wittebole X, Laterre PF, van der Poll T - Intensive Care Med (2010)

Bottom Line: Serum sST2 remained elevated in patients from day 0 to 14 and correlated with disease severity scores (P < 0.001) and cytokine levels on day 0 and during course of disease (P < 0.0001).Nonsurvivors displayed elevated sST2 levels compared with survivors of the intensive care unit (P < 0.0001).Sepsis results in sustained elevation of serum sST2 levels, which correlates with disease severity and mortality.

View Article: PubMed Central - PubMed

Affiliation: Center for Infection and Immunity Amsterdam (CINIMA), University of Amsterdam, Amsterdam, The Netherlands. j.j.hoogerwerf@amc.uva.nl

ABSTRACT

Purpose: Patients with sepsis-after surviving the initial hyperinflammatory phase-display features consistent with immunosuppression, including hyporesponsiveness of immunocompetent cells to bacterial agents. Immunosuppression is thought to be facilitated by negative regulators of toll-like receptors, including membrane-bound ST2. We investigated the release of soluble ST2 (sST2), a decoy receptor that inhibits membrane-bound ST2 signaling, during sepsis.

Methods: The study population comprised 95 patients with severe sepsis admitted to one of two intensive care units (ICUs) at the day the diagnosis of severe sepsis was made. Blood was obtained daily from admission (day 0) until day 7 and finally at day 14. Twenty-four healthy subjects served as controls. sST2 and cytokines were measured in serum.

Results: Mortality among patients was 34% in the ICU and 45% in the hospital. On admission, sepsis patients had higher sST2 levels [10,989 (7,871-15,342) pg/ml, geometric mean (95% confidence interval, CI)] than controls [55 (20-145) pg/ml, P < 0.0001]. Serum sST2 remained elevated in patients from day 0 to 14 and correlated with disease severity scores (P < 0.001) and cytokine levels on day 0 and during course of disease (P < 0.0001). Nonsurvivors displayed elevated sST2 levels compared with survivors of the intensive care unit (P < 0.0001).

Conclusions: Sepsis results in sustained elevation of serum sST2 levels, which correlates with disease severity and mortality.

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Related in: MedlinePlus

Elevated soluble ST2 levels correlate with mortality. Soluble ST2 levels in patients who left the ICU alive (n = 63; open squares) versus patients who died in the ICU (n = 32; filled squares) (a), in patients who left the hospital alive (n = 52; open squares) versus patients who died in the hospital (n = 43; filled squares) (b), and in patients who died in the ICU (n = 32; filled squares) versus patients who died in the hospital after ICU discharge (n = 11; open squares) (c). Data are geometric means with 95% confidence intervals. **P < 0.001, ***P < 0.0005
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Fig2: Elevated soluble ST2 levels correlate with mortality. Soluble ST2 levels in patients who left the ICU alive (n = 63; open squares) versus patients who died in the ICU (n = 32; filled squares) (a), in patients who left the hospital alive (n = 52; open squares) versus patients who died in the hospital (n = 43; filled squares) (b), and in patients who died in the ICU (n = 32; filled squares) versus patients who died in the hospital after ICU discharge (n = 11; open squares) (c). Data are geometric means with 95% confidence intervals. **P < 0.001, ***P < 0.0005

Mentions: Soluble ST2 levels were higher in patients who died in the ICU (n = 32) than in patients who left the ICU alive (n = 63); this difference between ICU survivors and nonsurvivors was sustained until day 14 (Fig. 2a). In this analysis we compared ICU survivors and nonsurvivors since cause of death in patients who died in the hospital after ICU discharge was mostly unrelated to sepsis. Although soluble ST2 levels between overall hospital survivors (n = 52) and overall nonsurvivors (n = 43) were significantly different (Fig. 2b), it appeared that soluble ST2 levels of patients who died in the hospital after ICU discharge (n = 11) were lower than those of patients who died in the ICU (n = 32) (Fig. 2c).Fig. 2


Soluble ST2 plasma concentrations predict mortality in severe sepsis.

Hoogerwerf JJ, Tanck MW, van Zoelen MA, Wittebole X, Laterre PF, van der Poll T - Intensive Care Med (2010)

Elevated soluble ST2 levels correlate with mortality. Soluble ST2 levels in patients who left the ICU alive (n = 63; open squares) versus patients who died in the ICU (n = 32; filled squares) (a), in patients who left the hospital alive (n = 52; open squares) versus patients who died in the hospital (n = 43; filled squares) (b), and in patients who died in the ICU (n = 32; filled squares) versus patients who died in the hospital after ICU discharge (n = 11; open squares) (c). Data are geometric means with 95% confidence intervals. **P < 0.001, ***P < 0.0005
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2837188&req=5

Fig2: Elevated soluble ST2 levels correlate with mortality. Soluble ST2 levels in patients who left the ICU alive (n = 63; open squares) versus patients who died in the ICU (n = 32; filled squares) (a), in patients who left the hospital alive (n = 52; open squares) versus patients who died in the hospital (n = 43; filled squares) (b), and in patients who died in the ICU (n = 32; filled squares) versus patients who died in the hospital after ICU discharge (n = 11; open squares) (c). Data are geometric means with 95% confidence intervals. **P < 0.001, ***P < 0.0005
Mentions: Soluble ST2 levels were higher in patients who died in the ICU (n = 32) than in patients who left the ICU alive (n = 63); this difference between ICU survivors and nonsurvivors was sustained until day 14 (Fig. 2a). In this analysis we compared ICU survivors and nonsurvivors since cause of death in patients who died in the hospital after ICU discharge was mostly unrelated to sepsis. Although soluble ST2 levels between overall hospital survivors (n = 52) and overall nonsurvivors (n = 43) were significantly different (Fig. 2b), it appeared that soluble ST2 levels of patients who died in the hospital after ICU discharge (n = 11) were lower than those of patients who died in the ICU (n = 32) (Fig. 2c).Fig. 2

Bottom Line: Serum sST2 remained elevated in patients from day 0 to 14 and correlated with disease severity scores (P < 0.001) and cytokine levels on day 0 and during course of disease (P < 0.0001).Nonsurvivors displayed elevated sST2 levels compared with survivors of the intensive care unit (P < 0.0001).Sepsis results in sustained elevation of serum sST2 levels, which correlates with disease severity and mortality.

View Article: PubMed Central - PubMed

Affiliation: Center for Infection and Immunity Amsterdam (CINIMA), University of Amsterdam, Amsterdam, The Netherlands. j.j.hoogerwerf@amc.uva.nl

ABSTRACT

Purpose: Patients with sepsis-after surviving the initial hyperinflammatory phase-display features consistent with immunosuppression, including hyporesponsiveness of immunocompetent cells to bacterial agents. Immunosuppression is thought to be facilitated by negative regulators of toll-like receptors, including membrane-bound ST2. We investigated the release of soluble ST2 (sST2), a decoy receptor that inhibits membrane-bound ST2 signaling, during sepsis.

Methods: The study population comprised 95 patients with severe sepsis admitted to one of two intensive care units (ICUs) at the day the diagnosis of severe sepsis was made. Blood was obtained daily from admission (day 0) until day 7 and finally at day 14. Twenty-four healthy subjects served as controls. sST2 and cytokines were measured in serum.

Results: Mortality among patients was 34% in the ICU and 45% in the hospital. On admission, sepsis patients had higher sST2 levels [10,989 (7,871-15,342) pg/ml, geometric mean (95% confidence interval, CI)] than controls [55 (20-145) pg/ml, P < 0.0001]. Serum sST2 remained elevated in patients from day 0 to 14 and correlated with disease severity scores (P < 0.001) and cytokine levels on day 0 and during course of disease (P < 0.0001). Nonsurvivors displayed elevated sST2 levels compared with survivors of the intensive care unit (P < 0.0001).

Conclusions: Sepsis results in sustained elevation of serum sST2 levels, which correlates with disease severity and mortality.

Show MeSH
Related in: MedlinePlus