title: Increased circulating soluble CD14 is associated with high mortality in gram-negative septic shock.
abstract: 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.
authors.affiliation: Department of Research, University Hospital, Basel, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Landmann
authors.forename: W
authors.initials: W
authors.lastname: Zimmerli
authors.forename: S
authors.initials: S
authors.lastname: Sansano
authors.forename: S
authors.initials: S
authors.lastname: Link
authors.forename: A
authors.initials: A
authors.lastname: Hahn
authors.forename: M P
authors.initials: MP
authors.lastname: Glauser
authors.forename: T
authors.initials: T
authors.lastname: Calandra
mesh_terms: 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*
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D018950:Lipopolysaccharide Receptors