Academic Journal
An early increase in endothelial protein C receptor is associated with excess mortality in pneumococcal pneumonia with septic shock in the ICU
| العنوان: | An early increase in endothelial protein C receptor is associated with excess mortality in pneumococcal pneumonia with septic shock in the ICU |
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| المؤلفون: | Chapelet, Agnès, Foucher, Yohann, Gérard, Nathalie, Rousseau, Christophe, Zambon, Olivier, Bretonnière, Cédric, Mira, Jean-Paul, Charreau, Béatrice, Guitton, Christophe |
| المساهمون: | Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Service de soins intensifs CHU Nantes, Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Immunoregulation And Immunointervention in Transplantation and Autoimmunity (Team 4 - U1064 Inserm - CRTI), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de Soins Intensifs CHU Cochin, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Réanimation médico-chirurgicale CH Le Mans, Centre Hospitalier Le Mans (CH Le Mans), Astellas., A grant from l’Association pour le Développement de la Réanimation (ADR, Nantes)., Nantes Metropole and the Pays de la Loire Region., “Fondation Centaure” (RTRS) which supports a French transplantation research network., ANR-10-IBHU-0005,CESTI (TSI-IHU),Centre Européen des Sciences de la Transplantation et de l'Immunothérapie (TSI-IHU)(2010), ANR-11-LABX-0016,IGO,Immunothérapies Grand Ouest(2011), ANR-10-IDEX-0002,UNISTRA,Par-delà les frontières, l'Université de Strasbourg(2010) |
| المصدر: | ISSN: 1364-8535. |
| بيانات النشر: | HAL CCSD BioMed Central |
| سنة النشر: | 2018 |
| المجموعة: | Université François-Rabelais de Tours: HAL |
| مصطلحات موضوعية: | In-hospital mortality, Predictive score, Early biomarker, Sepsis outcome, Pneumococcal pneumonia, Soluble EPCR, Sepsis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | International audience ; Background: This study investigated changes in plasma level of soluble endothelial protein C receptor (sEPCR) in association with outcome in patients with septic shock. We explored sEPCR for early sepsis prognosis assessment and constructed a scoring system based on clinical and biological data, in order to discriminate between surviving at hospital discharge and non-surviving patients.Methods: Clinical data and samples were extracted from the prospective “STREPTOGENE” cohort. We enrolled 278 patients, from 50 intensive care units (ICUs), with septic shock caused by pneumococcal pneumonia. Patients were divided into survivors (n =194) and non-survivors (n =84) based on in-hospital mortality. Soluble EPCR plasma levels were quantified at day 1 (D1) and day 2 (D2) by ELISA. The EPCR gene A3 haplotype was determined. Patients were followed up until hospital discharge. Univariate and multivariate analyses were performed. A scoring system was constructed using least absolute shrinkage and selection operator (lasso) logistic regression for selecting predictive variables.Results: In-hospital mortality was 30.2% (n =84). Plasma sEPCR level was significantly higher at D1 and D2 in nonsurviving patients compared to patients surviving to hospital discharge (p =0.0447 and 0.0047, respectively). Early increase in sEPCR at D2 was found in non-survivors while a decrease was observed in the survival group (p =0.0268). EPCR A3 polymorphism was not associated with mortality. Baseline sEPCR level and its variation from D1 to D2 were independent predictors of in-hospital mortality. The scoring system including sEPCR predicted mortality with an AUC of 0.75.Conclusions: Our findings confirm that high plasma sEPCR and its increase at D2 are associated with poor outcome in sepsis and thus we propose sEPCR as a key player in the pathogenesis of sepsis and as a potential biomarker of sepsis outcome. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | inserm-02157511; https://inserm.hal.science/inserm-02157511; https://inserm.hal.science/inserm-02157511/document; https://inserm.hal.science/inserm-02157511/file/13054_2018_Article_2179.pdf |
| DOI: | 10.1186/s13054-018-2179-6 |
| الاتاحة: | https://inserm.hal.science/inserm-02157511 https://inserm.hal.science/inserm-02157511/document https://inserm.hal.science/inserm-02157511/file/13054_2018_Article_2179.pdf https://doi.org/10.1186/s13054-018-2179-6 |
| Rights: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.270ACAE7 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13054-018-2179-6 |
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