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Crit Care. 2015 Nov 25;19:412. doi: 10.1186/s13054-015-1125-0.

Plasma fractalkine is a sustained marker of disease severity and outcome in sepsis patients.

Author information

1
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, G2-130, 1105 AZ, Amsterdam, The Netherlands. a.j.hoogendijk@amc.uva.nl.
2
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, G2-130, 1105 AZ, Amsterdam, The Netherlands. m.a.wiewel@amc.uva.nl.
3
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, G2-130, 1105 AZ, Amsterdam, The Netherlands. l.a.vanvught@amc.uva.nl.
4
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, G2-130, 1105 AZ, Amsterdam, The Netherlands. b.scicluna@amc.uva.nl.
5
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, G2-130, 1105 AZ, Amsterdam, The Netherlands. hakima1212@hotmail.com.
6
Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. j.horn@amc.uva.nl.
7
Clinical Epidemiology Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. a.h.zwinderman@amc.uva.nl.
8
Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. p.m.c.kleinklouwenberg@umcutrecht.nl.
9
Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands. p.m.c.kleinklouwenberg@umcutrecht.nl.
10
Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. o.l.cremer@umcutrecht.nl.
11
Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands. m.j.m.bonten@umcutrecht.nl.
12
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. m.j.m.bonten@umcutrecht.nl.
13
Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. marcus.j.schultz@gmail.com.
14
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, G2-130, 1105 AZ, Amsterdam, The Netherlands. t.vanderpoll@amc.uva.nl.
15
Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. t.vanderpoll@amc.uva.nl.

Abstract

INTRODUCTION:

Fractalkine is a chemokine implicated as a mediator in a variety of inflammatory conditions. Knowledge of fractalkine release in patients presenting with infection to the Intensive Care Unit (ICU) is highly limited. The primary objective of this study was to establish whether plasma fractalkine levels are elevated in sepsis and associate with outcome. The secondary objective was to determine whether fractalkine can assist in the diagnosis of infection upon ICU admission.

METHODS:

Fractalkine was measured in 1103 consecutive sepsis patients (including 271 patients with community-acquired pneumonia (CAP)) upon ICU admission and at days 2 and 4 thereafter; in 73 ICU patients treated for suspected CAP in whom this diagnosis was refuted in retrospect; and in 5 healthy humans intravenously injected with endotoxin.

RESULTS:

Compared to healthy volunteers, sepsis patients had strongly elevated fractalkine levels. Fractalkine levels increased with the number of organs failing, were higher in patients presenting with shock, but did not vary by site of infection. Non-survivors had sustained elevated fractalkine levels when compared to survivors. Fractalkine was equally elevated in CAP patients and patients treated for CAP but in whom the diagnosis was retrospectively refuted. Fractalkine release induced by intravenous endotoxin followed highly similar kinetics as the endothelial cell marker E-selectin.

CONCLUSIONS:

Plasma fractalkine is an endothelial cell derived biomarker that, while not specific for infection, correlates with disease severity in sepsis patients admitted to the ICU.

PMID:
26603530
PMCID:
PMC4658804
DOI:
10.1186/s13054-015-1125-0
[Indexed for MEDLINE]
Free PMC Article

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