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Shock. 2016 Mar;45(3):326-32. doi: 10.1097/SHK.0000000000000524.

PROGNOSTIC VALUE OF PLASMA TIGHT-JUNCTION PROTEINS FOR SEPSIS IN EMERGENCY DEPARTMENT: AN OBSERVATIONAL STUDY.

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1
*Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou †Trauma Research Center, First Hospital Affiliated the Chinese PLA General Hospital, Beijing, P.R. China.

Abstract

BACKGROUND:

Studies have illustrated that the breakdown of tight junction (TJ) contributed to an increase in vascular permeability in response to stimulation of inflammatory cytokines. Additionally, the release of TJ-associated proteins into the circulation was observed in many diseases. The present study was designed to investigate whether plasma levels of TJ-associated proteins could serve as predictors of severity and clinical outcome of sepsis.

METHODS:

In total, 51 septic patients were enrolled. The peripheral blood samples were collected for each patient on emergency department arrival. Plasma levels of occludin (OCLN), claudins (CLDN)-5, and zonula occludens (ZO)-1 and serum levels of procalcitonin (PCT) and lactate were measured. In addition, APACHE II score as well as SOFA score was calculated. The prognostic values of OCLN, CLDN-5, and ZO-1 were compared with the first 24-h maximum APACHE II score and SOFA score.

RESULTS:

The median levels of OCLN and ZO-1 were elevated with sepsis severity. The levels of plasma OCLN and ZO-1 were positively correlated with APACHE II score, SOFA score as well as lactate levels of the patients. The levels of ZO-1 revealed valuable diagnostic capacity to diagnose MODS, and the areas under the receiver-operating characteristic (AUC) curves of ZO-1 were similar to those of lactate levels, but better than those of PCT levels. The prognostic value for in-hospital mortality of ZO-1 was comparable to that of lactate levels, APACHE II score, and SOFA score, and superior to OCLN or PCT.

CONCULSIONS:

OCLN and ZO1 levels appear to be early prognostic markers in patients suffering from sepsis.

PMID:
26863122
DOI:
10.1097/SHK.0000000000000524
[Indexed for MEDLINE]

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