Oncostatin M: a Potential Biomarker to Predict Infection in Patients with Left Ventricular Assist Devices

Abstract

Infection is a serious adverse event limiting left ventricular assist device (LVAD) therapy in advanced heart failure patients, but a reliable means to identify patients at increased risk of infection is still lacking. We hypothesized that preoperative elevated levels of plasma Oncostatin M (OSM), a cytokine marker of leukocyte activation and inflammation, would be predictive of subsequent infection. We measured plasma OSM in 41 LVAD patients one day before LVAD implantation and postoperatively over two months. Preoperative plasma OSM levels were normal in 27 patients (group A, 4.9 ± 3.2 pg/ml) but elevated in 14 patients (group B, 1649.0 ± 458.9 pg/ml) (p = 0.003). Early postoperative levels rose in both groups and declined rapidly in group A, with group B declining slowly over two months. Significantly more infections developed in group B than group A patients over two months postimplantation (p = 0.004). No other routine clinical assessment or laboratory testing afforded this differentiation. These findings suggest that preoperative plasma OSM levels may assist in identifying patients at increased risk of infections after LVAD implantation.

Oncostatin M for characterizing the inflammatory burden and outcome of V‐V ECMO in ARDS patients

“…As illustrated in Figure 1, the patient population was separated into two groups, A and B, based on their absolute pOSM levels at presentation. Patients in group A ( n = 12, 40%) had their baseline pOSM levels (1.1 ± 3.8; 0 pg/mL) within the range of those found in normal, healthy subjects 8 . However, patients in group B ( n = 18, 60%) had their baseline pOSM levels markedly elevated (1548 ± 1999; 767 pg/mL) (Table 1A).…”

“…Plasma sample for measuring OSM was prepared as previously described. 7,8 Blood samples were centrifuged at 1650g for 20 min at 4°C within 30 min after collection. The plasma was separated, aliquoted in microfuge tubes and stored at −80°C until analyses were completed within 60 days of sample collection.…”

“…At each time point, two blood samples were collected in vacutainer tubes (BD BioSciences) – one with K 2 EDTA for OSM and one with fluoride for LA. Plasma sample for measuring OSM was prepared as previously described 7,8 . Blood samples were centrifuged at 1650 g for 20 min at 4°C within 30 min after collection.…”

“…Patients in group A (n = 12, 40%) had their baseline pOSM levels (1.1 ± 3.8; 0 pg/mL) within the range of those found in normal, healthy subjects. 8 However, patients in group B (n = 18, 60%) had their baseline pOSM levels markedly elevated (1548 ± 1999; 767 pg/mL) (Table 1A). In contrast, baseline absolute pLA levels were not significantly different between group A (2.1 ± 2.3; 1.9 mmol/L) and group B (1.8 ± 1.1; 1.4 mmol/L).…”

“…6,7 This notion was substantiated in our recent study that showed critical roles of neutrophil-released OSM in infection and inflammation. 7 Our subsequent studies revealed the ability of pOSM to function as a biomarker to predict risk of infections in patients with left ventricular assist devices (LVADs) 8 ; as well as to characterize the inflammatory burden in patients receiving LVADs, total artificial hearts (TAHs), and extracorporeal membrane oxygenation (ECMO) 8,9 In patients with ARDS, several reports had noted association of neutrophil accumulation with subsequent OSM deposition in lung tissues and elevated pOSM levels. [10][11][12] These observations suggest that OSM may serve as a reliable tool to characterize the inflammatory burden and potential outcomes of V-V ECMO support in this patient population.…”