Low Paraoxonase 1 Activity Predicts Mortality in Surgical Patients with Sepsis

Abstract

Introduction. State of severe oxidative stress is encountered in sepsis. Paraoxonase 1 (PON1) protects against oxidative stress but also undergoes inactivation upon that condition. We investigated PON1 activity in surgical patients with sepsis in relation to oxidative stress status, inflammation, disease severity, and survival. Methods. Prospective observational study. Sixty-nine surgical patients with sepsis were compared to 69 age/sex matched healthy controls. PON1 paraoxonase and diazoxonase activities, selected biochemical, hematological and oxidative stress parameters were measured on admission to ICU and 24, 48, 72, and 96 hours later. Disease severity scores were calculated daily. Results. Septic patients had significantly lower PON1 activities compared to control group at all time points. PON1 activities had good capacity to differentiate septic patients from healthy controls. Low PON1 activities were associated with higher disease severity scores and higher risk of death. Correlation between PON1 activity and markers of inflammation failed to reach significance. Decrease in PON1 activity was correlated with an increase in reducing components in plasma. Conclusion. Our study demonstrated lower PON1 activity in surgical patients with sepsis compared to healthy controls. PON1 activity also reflected severity of the disease. Low PON1 activity was associated with higher mortality of surgical patients with sepsis.

Serial measurements of Paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia

“…Differently from clinical signs and changes in WBC and plasma iron reported in the previous study [ 31 ], PON-1 activity recorded in the present study did not show significant changes in the first 12 h. On the contrary, a significant decrease in PON-1 activity was recorded starting from 48 h post-infusion, when all the other clinical and analytical parameters had returned to normal reference intervals. The simultaneous decrease in PON-1 activity and recovery from clinical signs is in contrast with those studies that in humans reported PON-1 increase when patients with naturally occurred sepsis clinically improved [ 18 , 19 , 22 ]. The same studies however [ 19 , 22 ], reported a sustained decrease in PON-1 activity for several days, which we also observed.…”

Serial measurements of Paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia

“…A progressive decrease in PON-1 activity from baseline was observed from 24 hours after the end of LPS infusion. (18,19,22). The same studies however (19,22), reported a sustained decrease in PON-1 activity for several days, which we also observed.…”

“…(18,19,22). The same studies however (19,22), reported a sustained decrease in PON-1 activity for several days, which we also observed. Our study is based on an experimental model of endotoxemia, which does not completely mimic the conditions and pathologic pathways of naturally occurring endotoxemia.…”

Plasmatic Soluble Receptor for Advanced Glycation End Products as a New Oxidative Stress Biomarker in Patients with Prosthetic-Joint-Associated Infections?

“…Neutrophils represent the first line defense against pathogen invasion, and, in order to combat S. aureus, neutrophils are able both to engulf bacteria through phagocytosis and to directly kill the bacteria by ROS production, leading to oxidative burst [ 12 ]. Oxidative burst is a major event characterizing the inflammatory response, and for this reason, markers of oxidative stress are currently used in the clinical evaluation of sepsis [ 11 , 13 ], but at the moment no evidence has described so far the use of OS stress evaluation in PJI diagnosis.…”