APRIL and sTACI could be predictors of multiorgan dysfunction syndrome in sepsis

Abstract

Although the role of B cells in sepsis immunoregulation has become an interesting topic, there is lack of data on the role of B cell function regulators in prediction of multiorgan dysfunction syndrome (MODS). The aim of this study was to evaluate the prognostic value of A Proliferation Inducing Ligand (APRIL) and soluble Transmembrane Activator and CAML Interactor Protein (sTACI), the main B cell function regulators, in prediction of MODS development within the first 48 h after admission to intensive care unit, among septic patients. We included 112 patients with sepsis, treated at Clinic for Infectious Diseases and Emergency Center, Clinical Center of Vojvodina, Novi Sad, Serbia. Plasma concentrations of APRIL and sTACI were determined at the admission and potential development of MODS was confirmed in the first 48 h. Concentrations of APRIL (p = 0.003) and sTACI (p<0.001) were higher in patients who developed MODS (n = 30). ROC curve analysis showed that AUC for sTACI (AUC = 0.764) was greater than that for procalcitonin (AUC = 0.719) and APRIL (AUC = 0.673) in MODS development prediction. Multivariate regression analysis showed that sTACI, as an anti-inflammatory biomarker stimulating the apoptosis of B cells, was the only independent predictor of MODS, beside SOFA score. Elevated level of sTACI could be the alarm for the increased B cell apoptosis and development of immune paralysis. Including these biomarkers into predictive scores specific for septic patients may potentially improve their sensitivity and specificity. Measurement of their concentrations dynamics could contribute to better assessment of sepsis evolution and timely introduction of immunomodulatory therapy.

MiR-940 Serves as a Diagnostic Biomarker in Patients with Sepsis and Regulates Sepsis-Induced Inflammation and Myocardial Dysfunction

“… 15 , 16 The inflammatory reaction caused by sepsis is mediated by cytokines, among which cytokines confirmed to be related to pathogenesis are divided into pro-inflammatory and anti-inflammatory. 17 As a severe common complication both in adults and children, myocardial damage accompanied by sepsis is characterized by increased factors of myocardial injury and increased mortality. 18 , 19 In spite of a great deal of achievement that has been done for decades, there is no specific treatment for sepsis so far.…”

Biomarkers of sepsis: time for a reappraisal

“…To diagnose infection in patients with a particular pathology/condition After cardiac surgery Endocan [92], CD64 [93], pancreatic stone protein [94] After major surgery Peptidoglycan [95], elastase [96], leptin [84], calprotectin [75], a proliferation-inducing ligand [97], α-2 macroglobulin [89], lipopolysaccharide-binding protein [15] COPD Pentraxin 3 [98] Cirrhosis Interleukin (IL)-6 [72] Trauma IL-10 [99], NT-proCNP [100], P-selectin [101] Catheter-related infections Citrulline [102] Infants with necrotic enterocolitis IP-10 [103]…”

Biomarkers of sepsis: Time for a Reappraisal

“…Additional le 1 (.pdf) Situation Biomarker To diagnose infection in patients with a particular pathology/condition After cardiac surgery Endocan [111], CD64 [112], pancreatic stone protein [113] After major surgery Peptidoglycan [114], elastase [115], leptin [103], calprotectin [94], a proliferation-inducing ligand [116], α-2 macroglobulin [108], lipopolysaccharide-binding protein [ To diagnose speci c types of infection Gram (-) vs Gram (+) Fibrin degradation products [128], lipopolysaccharidebinding protein [123], CD11b [106]…”