Document Detail


High C5a levels are associated with increased mortality in sepsis patients--no enhancing effect by actin-free Gc-globulin.
MedLine Citation:
PMID:  18538666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Olav A Gressner; Alexander Koch; Edouard Sanson; Christian Trautwein; Frank Tacke
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Publication Detail:
Type:  Journal Article     Date:  2008-05-27
Journal Detail:
Title:  Clinical biochemistry     Volume:  41     ISSN:  1873-2933     ISO Abbreviation:  Clin. Biochem.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-21     Completed Date:  2008-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0133660     Medline TA:  Clin Biochem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  974-80     Citation Subset:  IM    
Affiliation:
Institute of Clinical Chemistry and Pathobiochemistry, University Hospital Aachen, Aachen University (RWTH), Aachen, Germany. ogressner@ukaachen.de
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MeSH Terms
Descriptor/Qualifier:
Actins / 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:
0/Actins; 0/Biological Markers; 0/Vitamin D-Binding Protein; 80295-54-1/Complement C5a

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