Περίληψη:
Chemerin, a novel adipokine, is a potent chemoattractant molecule with
antimicrobial properties, implicated in immune responses. Our aim was to
investigate circulating chemerin and its kinetics, early in sepsis in
critically ill patients and its association with severity and prognosis.
Serum chemerin was determined in a cohort of 102 critically ill patients
with sepsis during the first 48 h from sepsis onset and one week later,
and in 102 age- and gender-matched healthy controls. Patients were
followed for 28 days and their outcomes were recorded. Circulating
chemerin was significantly higher in septic patients at onset compared
to controls (342.3 +/- 108.1 vs. 200.8 +/- 40.1 mu g/L, p < 0.001).
Chemerin decreased significantly from sepsis onset to one week later
(342.3 +/- 108.1 vs. 308.2 +/- 108.5 mu g/L, p < 0.001), but remained
higher than in controls. Chemerin was higher in patients presenting with
septic shock than those with sepsis (sepsis onset: 403.2 +/- 89.9 vs.
299.7 +/- 99.5 mu g/L, p < 0.001; one week after: 374.9 +/- 95.3 vs.
261.6 +/- 91.9 mu g/L, p < 0.001), and in nonsurvivors than survivors
(sepsis onset: 427.2 +/- 96.7 vs. 306.9 +/- 92.1 mu g/L, p < 0.001; one
week after: 414.1 +/- 94.5 vs. 264.2 +/- 79.9 mu g/L, p < 0.001).
Moreover, patients with septic shock and nonsurvivors, presented a
significantly lower absolute and relative decrease in chemerin one week
after sepsis onset compared to baseline (p < 0.001). Based on ROC curve
analyses, the diagnostic performance of chemerin (AUC 0.78, 95% CI
0.69-0.87) was similar to C-reactive protein (CRP) (AUC 0.78, 95% CI
0.68-0.87) in discriminating sepsis severity. However, increased
chemerin at sepsis onset and one week later was an independent predictor
of 28-day mortality (sepsis onset: HR 3.58, 95% CI 1.48-8.65, p =
0.005; one week after: HR 10.01, 95% CI 4.32-23.20, p < 0.001).
Finally, serum chemerin exhibited significant correlations with the
severity scores, white blood cells, lactate, CRP and procalcitonin, as
well as with biomarkers of glucose homeostasis, but not with cytokines
and soluble urokinase-type plasminogen activator receptor (suPAR).
Circulating chemerin is increased early in sepsis and its kinetics may
have diagnostic and prognostic value in critically ill patients. Further
studies are needed to shed light on the role of chemerin in sepsis.
Συγγραφείς:
Karampela, Irene
Christodoulatos, Gerasimos Socrates
Vallianou,
Natalia
Tsilingiris, Dimitrios
Chrysanthopoulou, Evangelia and
Skyllas, George
Antonakos, Georgios
Marinou, Ioanna and
Vogiatzakis, Evaggelos
Armaganidis, Apostolos
Dalamaga, Maria
