| High C5a levels are associated with increased mortality in sepsis patients--no enhancing effect by actin-free Gc-globulin. | |
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MedLine Citation:
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PMID: 18538666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Immune paralysis of phagocytic cells due to excess of the complement activation product C5a has been proposed as a critical pathomechanism in sepsis. In vitro studies suggest an interaction of C5a with Group-specific globulin (Gc-globulin). STUDY OBJECTIVES: To examine the predictive value of serum concentrations of both, C5a and actin-free Gc-globulin, and their ratio for prognosis (mortality) of critically ill patients. PATIENTS: 154 critically ill (septic and non-septic) adult patients admitted to a Medical ICU and 38 healthy controls. MEASUREMENTS: Actin-free Gc-globulin and C5a were measured on ICU admission, alongside extensive laboratory, clinical and prospective outcome measures. RESULTS: Actin-free Gc-globulin and C5a serum concentrations were significantly reduced in critically ill patients compared with healthy controls. C5a levels, but not actin-free Gc-globulin, were significantly lower in patients with sepsis (n=112) than in critically ill patients without sepsis (n=42). C5a serum level was a prognostic parameter in patients with sepsis: High C5a levels were associated with increased mortality (at ICU and during follow-up). Although C5a and actin-free Gc-globulin were positively correlated, increasing serum concentrations of actin-free Gc-globulin did not enhance the C5a dependent effects in terms of prognosis or mortality in septic patients. CONCLUSIONS: Investigation for C5a and/or actin-free Gc-globulin serum levels upon admission to the ICU may be helpful diagnostic tools. In patients with sepsis, C5a levels are an independent predictor of prognosis. However, different to pre-existing in vitro data, a clinically relevant interaction between actin-free Gc-globulin and C5a in terms of prognosis in severe inflammatory conditions is not given. |
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Authors:
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Olav A Gressner; Alexander Koch; Edouard Sanson; Christian Trautwein; Frank Tacke |
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Publication Detail:
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Type: Journal Article Date: 2008-05-27 |
Journal Detail:
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Title: Clinical biochemistry Volume: 41 ISSN: 1873-2933 ISO Abbreviation: Clin. Biochem. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-21 Completed Date: 2008-08-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0133660 Medline TA: Clin Biochem Country: United States |
Other Details:
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Languages: eng Pagination: 974-80 Citation Subset: IM |
Affiliation:
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Institute of Clinical Chemistry and Pathobiochemistry, University Hospital Aachen, Aachen University (RWTH), Aachen, Germany. ogressner@ukaachen.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Actins
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blood Adolescent Adult Aged Aged, 80 and over Analysis of Variance Biological Markers / blood Complement C5a / chemistry* Female Humans Intensive Care Units Male Middle Aged Prognosis Proportional Hazards Models ROC Curve Sepsis / diagnosis*, mortality* Statistics, Nonparametric Vitamin D-Binding Protein / blood* |
| Chemical | |
Reg. No./Substance:
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0/Actins; 0/Biological Markers; 0/Vitamin D-Binding Protein; 80295-54-1/Complement C5a |
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