Serial Changes in Plasma Annexin A1 and Cortisol Levels in Sepsis Patients

Abstract

Annexin A1 (AnxA1), originally identified as a glucocorticoid-regulated protein, is an impor- tant endogenous anti-inflammatory mediator during the resolution phase of inflammation, and its cir- culating level has been rarely studied in sepsis patients. Glucocorticoid has been extensively used in treating patients with sepsis. However, it is unclear whether endogenous cortisol or exogenous glucocor- ticoid contributes to the regulation of AnxA1 levels in peripheral blood of sepsis patients. The aim of this study was to investigate: [1] serial changes over time in the plasma levels of AnxA1 and cortisol in sepsis patients; and [2] prognostic value of AnxA1 level in the survival of sepsis patients. Fifty-eight adult sepsis patients admitted to an intensive care unit (ICU) were enrolled. The plasma levels of cortisol and AnxA1 were determined by specific enzyme-link immunosorbent assay. Results show that the median daily levels of cortisol at the 1st, 3rd, 5th and 7th day after admission to ICU were signifi- cantly elevated over the cortisol level of the control subjects. However, the AnxA1 level was elevated in only thirty-three patients (56%) over the observation period. There was no significant correlation between cortisol levels and AnxA1 levels. Further analysis indicated that steroid treatment resulted in significant elevation of the cortisol level over time, but did not affect the AnxA1 level. AnxA1 levels were also not statistically different between surviving and non-surviving patients. In conclusions, the circu- lating level of AnxA1 is elevated in a subgroup of sepsis patients, and the AnxA1 level does not correlate with the cortisol level in the peripheral blood of sepsis patients.

Damage-associated molecular patterns in trauma

“…Patients with uncomplicated recoveries had differential and higher resolving scores [ 65 ]. The SAMPs prostaglandin E2 or AnxA1 plays significant roles in proresolving CARS [ 66 – 68 ]. Accordingly, DAMPs and SAMPs constitute valuable tools in diagnosis and therapy of severely injured and/or infected patients that are expected to find their way into clinical routine at the ICUs.…”

Annexins in Translational Research: Hidden Treasures to Be Found

“…A caveat to the generalized use of AnxA1 for treatment of excess inflammatory conditions is the observation that LPS, a highly potent pro-inflammatory component derived from the bacterial wall of gram-negative bacteria, triggers the upregulation of AnxA1 expression in a variety of cell types e.g., neutrophils [ 78 ]. Indeed, elevated AnxA1 plasma levels are found in 56% of septic patients after hospital admission [ 79 ]. While initially beneficial [ 78 ], it remains to be investigated whether excess LPS-induced AnxA1 externalization might cause the so-called endotoxin resistance, a dangerous refractive state of the innate immune system characterized by a lowered response towards a second exposure to bacterial lipopolysaccharide [ 80 ].…”

Annexins in Translational Research: Hidden Treasures to be Found

“…neutrophils [73]. Indeed, elevated AnxA1 plasma levels are found in 56% of septic patients after hospital admission [74].…”