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Circulating levels of Peroxiredoxin 4 as a Novel Biomarker of Oxidative Stress in Patients with Sepsis.
MedLine Citation:
PMID:  21283059     Owner:  NLM     Status:  Publisher    
Oxidative stress, a situation with increased reactive oxygen species production and/or decreased antioxidant defense mechanisms, is evident in the pathogenesis of sepsis. Peroxiredoxin 4 (Prx4) is a hydrogen peroxide degrading peroxidase recently found circulating in blood of septic patients and potentially reflecting an antioxidant system in imbalance. We studied Prx4 serum levels of 79 consecutively enrolled medical intensive care unit patients. The diagnostic and prognostic performance of Prx4 was compared to other biomarkers, the Acute Physiological and Chronic Health Evaluation (APACHE) II score and the Sequential Organ Failure Assessment (SOFA) score. Median Prx4 serum levels gradually increased with disease severity in patients classified on admission as having systemic immune response syndrome (2.32 arb. U/L), sepsis (5.02 arb. U/L), severe sepsis (11.7 arb. U/L) or septic shock (11.4 arb. U/L). A positive correlation was found with the severity score APACHE II (r=0.27, P<0.05) and the organ failure score SOFA (r=0.55, P<0.0001). Prx4 correlated with the sepsis marker procalcitonin (r=0.61, P <0.0001), the inflammatory markers C-reactive protein (r=0.65, P <0.0001) and interleukin 6 (r=0.62, P <0.0001) as well as antioxidant blood compounds total bilirubin (r=0.37, P <0.001) and albumin (r=-0.54, P <0.0001). Prx4 distinguished non-infectious from infectious inflammatory response syndrome with an area under the receiver operating characteristic curve (AUC) of 0.83. High Prx4 serum levels were associated with a poor prognosis of septic patients and revealed an AUC of 0.76 in prediction of in-hospital mortality. In this study elevated serum levels of the antioxidant Prx4 were associated with an increased disease severity and adverse outcome of critically ill patients with sepsis. Prx4 may therefore be a helpful new biomarker for diagnosing, monitoring and risk assessing these patients. The pathophysiological mechanisms behind the observed increase remain to be elucidated.
Janin Schulte; Joachim Struck; Josef Köhrle; Beat Müller
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-24
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-2-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Thermo Fisher Scientific, BRAHMS Biomarkers, Research Department, 16761 Hennigsdorf, Germany 2Institute of Experimental Endocrinology, Charité Medical University Hospital Berlin, Augustenburger Platz 1, 13353 Berlin, Germany 3Medical University Clinic, Medical Faculty of the University Basel, Kantonsspital, Tellstraβe, 5001 Aarau, Switzerland.
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