Document Detail

Skin collagen synthesis is depressed in patients with severe sepsis.
MedLine Citation:
PMID:  20484539     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Skin is an essential barrier in maintaining a stable internal environment. Adequate regenerative capacity is crucial to overcome the homeostatic challenges caused by a septic insult. In sepsis, coagulation and inflammation are activated to restore homeostasis, but it is not known whether sepsis also alters tissue regeneration processes such as skin collagen synthesis. METHODS: In this prospective observational study, we measured aminoterminal propeptides of collagens I and III (PINP, PIIINP) from blister fluid of sepsis patients. Blister fluid was obtained from experimental blisters induced on intact abdominal skin 4 times: within the first 48 hours from the first organ failure, on the fifth day, and at 3 and 6 months thereafter. Forty-four patients with severe sepsis were enrolled. The median age was 63 years (25th-75th percentile, 53-71 years). The median Acute Physiology and Chronic Health Evaluation II score on admission was 26 (22-30). Thirty-day mortality was 25%. Fifteen healthy adults were used as controls. RESULTS: Median PIIINP and PINP levels in septic patients were lower in comparison with controls in the first blister (40.8 microg/L [25th-75th percentile, 22.2-77.1 microg/L], P = 0.028 and 69.9 microg/L [32.4-112.7 microg/L], P < 0.001, respectively) and in the blister induced on day 5 (38.8 microg/L [19.9-68.5 microg/L], P < 0.001 and 90.0 [35.1-138.8 microg/L], P < 0.001, respectively). The survivors revealed an overexpression at 3 months, whereas normal values of PIIINP and PINP were reestablished at 6 months. CONCLUSIONS: Skin collagen synthesis is depressed during severe sepsis and is followed by a compensatory response 3 and 6 months after the onset of sepsis.
Fiia P Gäddnäs; Marjo Koskela; Vesa Koivukangas; Jouko Laurila; Juha Saarnio; Juha Risteli; Aarne Oikarinen; Tero Ala-Kokko
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-19
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  111     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  156-63     Citation Subset:  AIM; IM    
Department of Anaesthesiology, Division of Intensive Care, Oulu University Hospital, P.O. Box 21, FI-90029 Oulu, Finland.
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MeSH Terms
Collagen / biosynthesis*
Collagen Type I / metabolism
Collagen Type III / metabolism
Intensive Care
Lactic Acid / metabolism
Middle Aged
Procollagen / biosynthesis
Prospective Studies
Sepsis / metabolism*
Skin / metabolism*
Specimen Handling
Treatment Outcome
Reg. No./Substance:
0/Collagen Type I; 0/Collagen Type III; 0/Procollagen; 50-21-5/Lactic Acid; 9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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