Changes in ceruloplasmin activity and lactate concentration in patients at high risk of acute organ system failure

Dauberschmidt, R; Mrochen, H; Förster, Irmgard; Stumpe, Christa; Dressler, C; Grajetzki, Hans; Meyer, Manuela

doi:10.1016/0009-8981(91)90108-o

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…Ceruloplasmin has been discussed as an acute phase reactant; however, as in our data, others have found ceruloplasmin (the major copper transport protein) to be normal or low in ICU patients. 18 Similar to our data, others have found elevated chromium levels in critically ill patients. 5…”

Section: Study Participant Nutrition Interventions Are Shown In Tablesupporting

confidence: 92%

Serum micronutrient levels in critically ill patients receiving continuous renal replacement therapy: A prospective, observational study

Gündoğan

Yucesoy

Özer

et al. 2022

J Parenter Enteral Nutr

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Background: Acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) may deplete micronutrient levels. Patients are also at risk for micronutrient depletion due to underlying illness(s), poor nutrient intake prior to intensive care unit (ICU) admission and/or increased requirements. We determined vitamin and trace element status before, during and after CRRT in critically ill patients.Methods: This prospective observational study performed in mixed medical and surgical ICU patients. Serial serum vitamin B6 and vitamin C concentrations were measured by HPLC and folic acid by ECLIA. Serum chromium, copper, selenium, and zinc were measured using ICP-MS. Serum ceruloplasmin was measured by the Erel method.Results: Fifty adult ICU patients with AKI were recruited. The median APACHE II score on ICU admission was high at 24.0 (6.0-33.0). The median days on CRRT was 2.0 (2.0-4.0) days. At baseline (within 10-15 minutes of CRRT initiation), serum vitamin C, selenium and zinc were below normal. Serum vitamin B6 levels at 72 hours on CRRT were significantly lower than at 24 hours (p = 0.011). Serum vitamin C values fell significantly at 24 and 72 hours during CRRT (p = 0.030 and p = 0.001), respectively, and remained low 24 and 48 hours after CRRT was stopped (p = 0.021). At baseline and during CRRT, 96% of participants had at least two or more micronutrient levels below the normal range. Conclusion:Serum vitamin C, selenium and zinc concentrations were below the normal range at baseline. CRRT was associated with a significant further decrease in levels of vitamin C, selenium and zinc.

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Section: Study Participant Nutrition Interventions Are Shown In Tablesupporting

confidence: 92%

Serum micronutrient levels in critically ill patients receiving continuous renal replacement therapy: A prospective, observational study

Gündoğan

Yucesoy

Özer

et al. 2022

J Parenter Enteral Nutr

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“…Thus, Cp is vital for proper iron metabolism, and genetic Cp deficiencies lead to accumulation of iron in organs (100). Moreover, low Cp levels have been associated with patients having a high risk for acute organ failure (101). It has also been shown that Cp activity decreases during hemolytic conditions such as trauma and burn injuries, contributing to inflammation and hypoferremia (100,102).…”

Section: Other Serum Proteins Involved In Regulating Hemolytic By-pro...mentioning

confidence: 99%

Engineering Therapeutics to Detoxify Hemoglobin, Heme, and Iron

Pires

Berthiaume

Palmer

2023

Annu. Rev. Biomed. Eng.

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Hemolysis (i.e., red blood cell lysis) can increase circulatory levels of cell-free hemoglobin (Hb) and its degradation by-products, namely heme (h) and iron (Fe). Under homeostasis, minor increases in these three hemolytic by-products (Hb/h/Fe) are rapidly scavenged and cleared by natural plasma proteins. Under certain pathophysiological conditions, scavenging systems become overwhelmed, leading to the accumulation of Hb/h/Fe in the circulation. Unfortunately, these species cause various side effects such as vasoconstriction, hypertension, and oxidative organ damage. Therefore, various therapeutics strategies are in development, ranging from supplementation with depleted plasma scavenger proteins to engineered biomimetic protein constructs capable of scavenging multiple hemolytic species. In this review, we briefly describe hemolysis and the characteristics of the major plasma-derived protein scavengers of Hb/h/Fe. Finally, we present novel engineering approaches designed to address the toxicity of these hemolytic by-products.

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“…Lack of Cp results in the degradation of ferroportin. As an acute phase protein, plasma Cp levels typically rise in inflammatory states [ 17 , 18 , 19 ], but early time points of Cp activity have not been carefully examined.…”

Section: Introductionmentioning

confidence: 99%

Ceruloplasmin and Hypoferremia: Studies in Burn and Non-Burn Trauma Patients

et al. 2015

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Objective: Normal iron handling appears to be disrupted in critically ill patients leading to hypoferremia that may contribute to systemic inflammation. Ceruloplasmin (Cp), an acute phase reactant protein that can convert ferrous iron to its less reactive ferric form facilitating binding to ferritin, has ferroxidase activity that is important to iron handling. Genetic absence of Cp decreases iron export resulting in iron accumulation in many organs. The objective of this study was to characterize iron metabolism and Cp activity in burn and non-burn trauma patients to determine if changes in Cp activity are a potential contributor to the observed hypoferremia. Material and Methods: Under Brooke Army Medical Center Institutional Review Board approved protocols, serum or plasma was collected from burn and non-burn trauma patients on admission to the ICU and at times up to 14 days and measured for indices of iron status, Cp protein and oxidase activity and cytokines. Results: Burn patients showed evidence of anemia and normal or elevated ferritin levels. Plasma Cp oxidase activity in burn and trauma patients were markedly lower than controls on admission and increased to control levels by day 3, particularly in burn patients. Plasma cytokines were elevated throughout the 14 days study along with evidence of an oxidative stress. No significant differences in soluble transferrin receptor were noted among groups on admission, but levels in burn patients were lower than controls for the first 5 days after injury. Conclusion: This study further established the hypoferremia and inflammation associated with burns and trauma. To our knowledge, this is the first study to show an early decrease in Cp oxidase activity in burn and non-burn trauma patients. The results support the hypothesis that transient loss of Cp activity contributes to hypoferremia and inflammation. Further studies are warranted to determine if decreased Cp activity increases the risk of iron-induced injury following therapeutic interventions such as transfusions with blood that has undergone prolonged storage in trauma resuscitation.

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Changes in ceruloplasmin activity and lactate concentration in patients at high risk of acute organ system failure

Cited by 6 publications

References 13 publications

Serum micronutrient levels in critically ill patients receiving continuous renal replacement therapy: A prospective, observational study

Serum micronutrient levels in critically ill patients receiving continuous renal replacement therapy: A prospective, observational study

Engineering Therapeutics to Detoxify Hemoglobin, Heme, and Iron

Ceruloplasmin and Hypoferremia: Studies in Burn and Non-Burn Trauma Patients

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