Increased circulating soluble CD14 is associated with high mortality in gram-negative septic shock.
The soluble glycoprotein sCD14 binds lipopolysaccharide, a complex that activates endothelial cells and that may be crucial in gram-negative sepsis. Therefore, serum sCD14 was analyzed in 54 patients with gram-negative septic shock and in 26 healthy controls. sCD14 was tested by ELISA and Western blotting. Patients had higher sCD14 concentrations than controls (median, 3.23 vs. 2.48 micrograms/mL, P = .002). Increased levels were associated with high mortality (median, 4.2 micrograms/mL in nonsurvivors vs. 2.8 micrograms/mL in survivors, P = .001). sCD14 was found in two isoforms (49 and 55 kDa) in monocyte cultures. In sera only one of either form was detectable. Controls had the 49-kDa form, and patients had either the 49- or 55-kDa form, but patients with high levels of sCD14 had only the 55-kDa form. Twenty-one (53%) of 39 with the 55-kDa form and 8 (57%) of 14 with the 49-kDa form died. Thus, the level of sCD14 but not its biochemical form had a prognostic value in patients with gram-negative septic shock.
Landmann
R
R
Department of Research, University Hospital, Basel, Switzerland.
Zimmerli
W
W
Sansano
S
S
Link
S
S
Hahn
A
A
Glauser
M P
MP
Calandra
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood*; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood*; D015153:Blotting, Western; D002648:Child; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood*; D006801:Humans; D018950:Lipopolysaccharide Receptors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood*
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D018950:Lipopolysaccharide Receptors