Document Detail


Increased plasma kynurenine values and kynurenine: tryptophan ratios after major trauma are early indicators for the development of sepsis.
MedLine Citation:
PMID:  19106813     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Kynurenine, the major degradation product of tryptophan has been shown to directly damage tissues but its possible contribution to posttraumatic morbidity is unknown. Herein, we studied the kinetics of kynurenine in patients after major trauma and whether this correlates with development of posttraumatic sepsis.Kynurenine and tryptophan of 60 multiple injured patients with Injury Severity Score (ISS) > 16 were quantified prospectively by high-performance liquid chromatography (HPLC). Blood samples were obtained daily from admission until day 10 after admission.Significantly increased kynurenine values were detectable already at day 1 after admission in blood from patients that later developed sepsis, regardless of injury pattern (p<0.01). In contrast, kynurenine values of non-septic patients remained low throughout the observation period. However, all patients exhibited significantly decreased tryptophan values versus healthy controls (p<0.01). Moreover, significantly increased kynurenine:tryptophan ratios rapidly predicted subsequent sepsis, multiple organ failure, and death (p<0.01).Both, increased kynurenine values and kynurenine:tryptophan ratios predicted posttraumatic development of sepsis and organ failure. This ought to be validated in subsequent studies.
Authors:
Tim T Lögters; Maurice D Laryea; Jens Altrichter; Janina Sokolowski; Jindrich Cinatl; Jenny Reipen; Wolfgang Linhart; Joachim Windolf; Martin Scholz; Micheal Wild
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2008-12-22
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Germany, 2Department of General Paediatrics, University Hospital Düsseldorf, Germany, 3Institute for Medical Virology, Johann Wolfgang Goethe University, Frankfurt am, Main, Germany.
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